Provider Demographics
NPI:1942395199
Name:WINNIE-STOWELL VOLUNTEER EMERGENCY MEDICAL SERVICES
Entity type:Organization
Organization Name:WINNIE-STOWELL VOLUNTEER EMERGENCY MEDICAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:WAHLEITHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-284-7972
Mailing Address - Street 1:PO BOX 227377
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75222-7377
Mailing Address - Country:US
Mailing Address - Phone:877-602-2060
Mailing Address - Fax:800-353-2196
Practice Address - Street 1:249 BROADWAY
Practice Address - Street 2:
Practice Address - City:WINNIE
Practice Address - State:TX
Practice Address - Zip Code:77665
Practice Address - Country:US
Practice Address - Phone:409-296-9627
Practice Address - Fax:409-296-9236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX036003341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
590015404OtherRAILROAD
TX1942395199Medicaid
590015404OtherRAILROAD
TX513617Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER