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Organization

BLACKBIRD ENTERPRISES, LLC

Active
Other names
Allegiance Ambulance
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID PHILLIPS (OWNER)
(254) 935-2424
Entity
Organization

Contact information

Practice address
422 CHAMPIONS DR, GEORGETOWN, TX 78628-1184
(254) 935-2424
(903) 887-1863
Mailing address
PO BOX 2775, GEORGETOWN, TX 78627-2775
(254) 935-2424
(903) 887-1863

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1000781
LICENSE
TX
Enumeration date
02/08/2012
Last updated
02/20/2012
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