Organization
COUNTY OF WISE
Active
Other names
Wise County EMS
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL PREUNINGER (EMS ADMINISTRATOR)
(940) 627-2002
Entity
Organization
Contact information
Practice address
1101 ROSE AVE., DECATUR, TX 76234
(940) 627-2002
(940) 627-7521
Mailing address
1101 W ROSE AVE, DECATUR, TX 76234-3304
(940) 627-2002
(940) 627-7521
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
249008
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
088232601
—
TX
01
—
514948
BC/BS OF TEXAS
TX
01
—
590005964
RAILROAD MEDICARE
—
Enumeration date
07/29/2006
Last updated
04/24/2024
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