Basic Information
| Provider Information | |||||||||
| NPI: | 1295042547 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | EMCARE MANAGEMENT SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1717 MAIN ST STE 5200 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752017365 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3616618000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2500 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | ALICE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 783324169 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3616618000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2010 | ||||||||
| LastUpdateDate: | 09/08/2010 | ||||||||
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| AuthorizedOfficialLastName: | THOMAS | ||||||||
| AuthorizedOfficialFirstName: | LATORIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | SENIOR ENROLLMENT SPECIALIST | ||||||||
| AuthorizedOfficialTelephone: | 2147122096 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | EMCARE MANAGEMENT SERVICES | ||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 313M00000X | 697387 | TX | Y | Nursing & Custodial Care Facilities | Nursing Facility/Intermediate Care Facility |
No ID Information.