Provider Demographics
NPI:1396896429
Name:KING COUNTY EMS, INC.
Entity type:Organization
Organization Name:KING COUNTY EMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADBURY
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-B
Authorized Official - Phone:806-596-4111
Mailing Address - Street 1:P.O. BOX 111
Mailing Address - Street 2:800 S BAKER STREET
Mailing Address - City:GUTHRIE
Mailing Address - State:TX
Mailing Address - Zip Code:79236-0111
Mailing Address - Country:US
Mailing Address - Phone:806-596-4111
Mailing Address - Fax:806-596-4044
Practice Address - Street 1:800 S BAKER STREET
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:TX
Practice Address - Zip Code:79236-0111
Practice Address - Country:US
Practice Address - Phone:806-596-4111
Practice Address - Fax:806-596-4044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1350023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX528164Medicare ID - Type UnspecifiedAMBULANCE SERVICE