Provider Demographics
NPI:1194723387
Name:ORANGE COUNTY AMBULANCE SERVICE, INC.
Entity type:Organization
Organization Name:ORANGE COUNTY AMBULANCE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MISSY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-883-0230
Mailing Address - Street 1:1502 STRICKLAND DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-3050
Mailing Address - Country:US
Mailing Address - Phone:409-883-0230
Mailing Address - Fax:409-883-0388
Practice Address - Street 1:608 STRICKLAND DR
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-4717
Practice Address - Country:US
Practice Address - Phone:409-883-6414
Practice Address - Fax:409-883-4917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1810063416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA05070916Medicaid
TXA05070916Medicaid