Waller County Volunteer EMS, Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

300114 Issued in TX

Legal business name

WALLER COUNTY VOLUNTEER EMS, INC

Practice address

1134 Austin St
Hempstead, TX 77445-4428

Phone

(979) 826-6063

Fax

(979) 826-0205

NPI assigned

Mar 10, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Archie Hashaw Jr.

Title

Executive Director

Phone

(979) 826-6063

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Waller County EMS Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399420800000",
    "number": "1801864368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1134 AUSTIN ST",
            "city": "HEMPSTEAD",
            "state": "TX",
            "postal_code": "774454428",
            "telephone_number": "979-826-6063",
            "fax_number": "979-826-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1134 AUSTIN ST",
            "city": "HEMPSTEAD",
            "state": "TX",
            "postal_code": "774454428",
            "telephone_number": "979-826-6063",
            "fax_number": "979-826-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLER COUNTY VOLUNTEER EMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2014-05-07",
        "status": "A",
        "authorized_official_last_name": "HASHAW",
        "authorized_official_first_name": "ARCHIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "979-826-6063",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TX",
            "license": "300114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1635839",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000631401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waller County EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jose Javier Torres Perez
• Arlizza Velasquez
• Wal-Mart Stores Texas LLC
• Waller County Chiropractic and Wellness LLC
• Waller County Chiropracticand Medical Solutions
• Daaiyah Ward
• Zahkia Wilkinson
• Cherise Davena Williams
• Chandra Denise Wright, RPH

• Land Ambulance in Hempstead, TX
• Providers in Hempstead, TX by specialty
• Land Ambulance in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.