Organization
LABELLE FANNETT VOLUNTEER FIRE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT WADE (EMS COORDINATOR)
(409) 794-1441
Entity
Organization
Contact information
Practice address
18769 FM 365 RD, BEAUMONT, TX 77705-8761
(409) 794-1441
Mailing address
2800 BEAUMONT AVE, LIBERTY, TX 77575-5137
(888) 483-9893
(936) 334-9861
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
123012
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000471501
—
TX
01
—
515710
BC/BS
TX
Enumeration date
04/20/2007
Last updated
04/10/2012
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