# POSSUM KINGDOM LAKE VOLUNTEER EMS INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346762382
- **Authorized official:** MS. TINA ULBRICH PARAMEDIC (ASST EMS DIRECTOR)
- **Authorized official phone:** (940) 452-5933

## Contact information

- **Practice address:** 358 N FM 2353, GRAFORD, TX 76449
- **Practice address phone:** (940) 779-2390
- **Practice address fax:** (940) 779-2003
- **Mailing address:** 344 N FM 2353 UNIT A, GRAFORD, TX 76449-1943
- **Mailing address phone:** (940) 452-5933
- **Mailing address fax:** (940) 779-2003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333300000X | Emergency Response System Companies | — | NULL | Yes |

## Other

- **Enumeration date:** 07/12/2017
- **Last updated:** 07/12/2017