Healthcare Provider Details

I. General information

NPI: 1699880765
Provider Name (Legal Business Name): EMERGENCY MEDICAL SERVICE COMPRISING INDEPENDENT SCHOOL DIST. #1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 06/07/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 WESTBLANCHARD DRIVE
BLANCHARD OK
73010-0430
US

IV. Provider business mailing address

PO BOX 430
BLANCHARD OK
73010-0430
US

V. Phone/Fax

Practice location:
  • Phone: 405-485-2000
  • Fax: 405-485-2010
Mailing address:
  • Phone: 405-485-2000
  • Fax: 405-485-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberEMS222
License Number StatePR

VIII. Authorized Official

Name: MRS. ROBIN ROBINSON
Title or Position: DIRECTOR
Credential: BSN, RN, NREMT-P
Phone: 405-485-2000