Healthcare Provider Details

I. General information

NPI: 1386600658
Provider Name (Legal Business Name): MARSHALL COUNTY AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NUMBER FOUR HOSPITAL DRIVE
MADILL OK
73446-0707
US

IV. Provider business mailing address

PO BOX 707 NUMBER 4 HOSPITAL DR
MADILL OK
73446-0707
US

V. Phone/Fax

Practice location:
  • Phone: 580-795-7541
  • Fax: 580-795-3629
Mailing address:
  • Phone: 580-795-7541
  • Fax: 580-795-3629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateOK

VIII. Authorized Official

Name: MRS. DEBRA SUE ROGERS
Title or Position: OFFICE MANAGER
Credential:
Phone: 580-795-7541