Mims Volunteer Fire Department
Organization Active NPI Land Ambulance · Avinger, TX
NPI 1639206899 · NPPES record last updated Oct 25, 2012
Key facts
- NPI
- 1639206899
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 300161 (TX)
- Legal business name
- MIMS VOLUNTEER FIRE DEPARTMENT
- Practice address
- 12728 FM 729
Avinger, TX 75630-8470 - Phone
- (903) 755-4112
- Fax
- (903) 755-3219
- NPI assigned
- Feb 27, 2007
- Organization subpart
- No
Authorized official
- Name
- Ms. June Rose
- Title
- Secretary/Treasurer
- Phone
- (903) 755-4112
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101028001471 | TX | Part B Supplier - Ambulance Service Supplier | 1658565197 | Practice locations: Avinger, TX |
National Provider Directory
Locations
12728 FM 729
Avinger, TX 75630
Phone (903) 755-4112
9902 FM 729
Avinger, TX 75630
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 300161 | TX | Yes |
Addresses
Primary practice location
12728 FM 729
Avinger, TX 75630-8470
Mailing address
12728 FM 729
Avinger, TX 75630-8470
Phone (903) 755-4112
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000457-01 | Medicaid | TX |
Other names
- Mims VFD & Ambulance
Other providers in Avinger, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.