MEDICARE: CITY OF GUTHRIE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	EMS152	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649277187
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF GUTHRIE

Provider Business Mailing Address
First Line	:	PO BOX 908
Second Line	:
City	:	GUTHRIE
State	:	OK
Zip	:	73044-0908
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	209 E SPRINGER AVE
Second Line	:
City	:	GUTHRIE
State	:	OK
Zip	:	73044-4831
Country	:	US
Telephone Number	:	405-282-0313
Fax Number	:

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	LESTER WAYNE BRANCH
Credential	:
Telephone Number	:	405-282-4433

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	11/10/2009

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Directions to “CITY OF GUTHRIE ” Practice Location

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