Healthcare Provider Details

I. General information

NPI: 1104809102
Provider Name (Legal Business Name): TOWN OF STRATFORD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 07/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E MAIN
STRATFORD OK
74872-0569
US

IV. Provider business mailing address

PO BOX 569
STRATFORD OK
74872-0569
US

V. Phone/Fax

Practice location:
  • Phone: 580-759-2371
  • Fax: 580-759-2372
Mailing address:
  • Phone: 580-759-2371
  • Fax: 580-759-2372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License NumberEMS097
License Number StateOK

VIII. Authorized Official

Name: MS. LORI JOLLEY
Title or Position: TOWN CLERK
Credential:
Phone: 580-759-2371