Healthcare Provider Details

I. General information

NPI: 1902053697
Provider Name (Legal Business Name): TOWN OF WESTVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2008
Last Update Date: 08/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 S. WILLIAMS
WESTVILLE OK
74965-0146
US

IV. Provider business mailing address

PO BOX 146
WESTVILLE OK
74965-0146
US

V. Phone/Fax

Practice location:
  • Phone: 918-723-3988
  • Fax: 918-723-3357
Mailing address:
  • Phone: 918-723-3988
  • Fax: 918-723-3357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberEMS434
License Number StateOK

VIII. Authorized Official

Name: HAROLD RAY SALLEE
Title or Position: EMS DIRECTOR
Credential:
Phone: 918-723-3988