Organization
LIPAN AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MASCHA TAYLOR REG MA (BILLING MGR)
(903) 473-0927
Entity
Organization
Contact information
Practice address
204 E LIPAN DR, LIPAN, TX 76462-2206
(903) 473-0927
(832) 877-5040
Mailing address
PO BOX 277, LIPAN, TX 76462-0277
(903) 473-0927
(832) 877-5040
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
111003
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140460001
—
TX
01
—
504330
BCBS TEXAS
TX
Enumeration date
06/10/2005
Last updated
06/30/2008
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