Provider Demographics
NPI:1548342108
Name:MEDIC RESCUE INC
Entity type:Organization
Organization Name:MEDIC RESCUE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-772-0330
Mailing Address - Street 1:PO BOX 2125
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-5025
Mailing Address - Country:US
Mailing Address - Phone:972-772-0330
Mailing Address - Fax:972-772-0331
Practice Address - Street 1:809 S GOLIAD ST
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-3933
Practice Address - Country:US
Practice Address - Phone:972-772-0330
Practice Address - Fax:972-772-0331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3001003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0006165-01Medicaid
TX0006165-01Medicaid