# LABELLE FANNETT VOLUNTEER FIRE

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

## Provider details

- **NPI number:** 1568689461
- **Authorized official:** SCOTT WADE (EMS COORDINATOR)
- **Authorized official phone:** (409) 794-1441

## Contact information

- **Practice address:** 18769 FM 365 RD, BEAUMONT, TX 77705-8761
- **Practice address phone:** (409) 794-1441
- **Mailing address:** 2800 BEAUMONT AVE, LIBERTY, TX 77575-5137
- **Mailing address phone:** (888) 483-9893
- **Mailing address fax:** (936) 334-9861

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 123012 | TX | Yes |

## Other

- **Enumeration date:** 04/20/2007
- **Last updated:** 04/10/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000471501 | — | TX |
| 01 | — | 515710 | BC/BS | TX |