Provider Demographics
NPI:1053925636
Name:CODE 4 EMERGENCY SERVICES LLC
Entity type:Organization
Organization Name:CODE 4 EMERGENCY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LP
Authorized Official - Phone:888-912-6334
Mailing Address - Street 1:1901 E 51ST ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3040
Mailing Address - Country:US
Mailing Address - Phone:888-912-6334
Mailing Address - Fax:888-912-6334
Practice Address - Street 1:1901 E 51ST ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3040
Practice Address - Country:US
Practice Address - Phone:888-912-6334
Practice Address - Fax:888-912-6334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes341600000XTransportation ServicesAmbulance
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX800923OtherDSHS FRO
45D2190889OtherCLIA
30471OtherCOLA
30471OtherCOLA