Provider Demographics
NPI:1679775399
Name:ROBERTSON COUNTY EMS, INC.
Entity type:Organization
Organization Name:ROBERTSON COUNTY EMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CALVIN
Authorized Official - Middle Name:RENNE
Authorized Official - Last Name:DEAL
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:979-828-4911
Mailing Address - Street 1:P.O. BOX 625
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TX
Mailing Address - Zip Code:77856-0625
Mailing Address - Country:US
Mailing Address - Phone:979-828-4911
Mailing Address - Fax:979-828-3333
Practice Address - Street 1:285 COOKS LANE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TX
Practice Address - Zip Code:77856
Practice Address - Country:US
Practice Address - Phone:979-828-4911
Practice Address - Fax:979-828-3333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX198008341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000189301Medicaid