# COUNTY OF WISE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wise County EMS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891700753
- **Authorized official:** RANDALL PREUNINGER (EMS ADMINISTRATOR)
- **Authorized official phone:** (940) 627-2002

## Contact information

- **Practice address:** 1101 ROSE AVE., DECATUR, TX 76234
- **Practice address phone:** (940) 627-2002
- **Practice address fax:** (940) 627-7521
- **Mailing address:** 1101 W ROSE AVE, DECATUR, TX 76234-3304
- **Mailing address phone:** (940) 627-2002
- **Mailing address fax:** (940) 627-7521

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 249008 | TX | Yes |

## Other

- **Enumeration date:** 07/29/2006
- **Last updated:** 04/24/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 088232601 | — | TX |
| 01 | — | 514948 | BC/BS OF TEXAS | TX |
| 01 | — | 590005964 | RAILROAD MEDICARE | — |