1699730259 NPI number — TOWN OF BURNS FLAT WASHITA CO

Table of content: (NPI 1699730259)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699730259 NPI number — TOWN OF BURNS FLAT WASHITA CO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWN OF BURNS FLAT WASHITA CO
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BURNS FLAT AMBULANCE
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699730259
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/06/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 410
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BURNS FLAT
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73624-0410
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
580-562-3144
Provider Business Mailing Address Fax Number:
580-562-3146

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
TOWN HALL S. HWY 44
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BURNS FLAT
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-562-3144
Provider Business Practice Location Address Fax Number:
580-562-3146
Provider Enumeration Date:
04/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BLOOMER
Authorized Official First Name:
DEBBIE
Authorized Official Middle Name:
Authorized Official Title or Position:
EMS DIRECTOR
Authorized Official Telephone Number:
580-562-3144

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  EMS084 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100818500A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com