Organization
SOMERVELL COUNTY FIRE DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK CRAWFORD (FIRE CHIEF)
(817) 690-6163
Entity
Organization
Contact information
Practice address
111 SHEPARD STREET, GLEN ROSE, TX 76043-4861
(254) 897-2135
(254) 897-4568
Mailing address
111 SHEPARD STREET, GLEN ROSE, TX 76043-4861
(254) 897-2135
(254) 897-4568
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
213004
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912016106
NOVITAS SOLUTIONS
TX
01
—
45D1027599
CENTERS FOR MEDICARE AND MEDICAID SERVICES (CLIA)
TX
Enumeration date
08/05/2015
Last updated
08/06/2015
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