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General NPI Number Information
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NPI Number | 1093736746
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Entity Type | Organization
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Legal Business Name | MAYES EMERGENCY SERVICES TRUST AUTHORITY
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 03/13/2012
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Provider Practice Location Address
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Address Line | 4 REDDEN
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City | PRYOR
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State | OK
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Zip | 74361-8800
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Country | US
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Telephone | 918-825-6825
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Fax | 918-825-6234
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Provider Business Mailing Address
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Address Line | 4 REDDEN
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City | PRYOR
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State | OK
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Zip | 74361-8800
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Country | US
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Telephone | 918-825-6825
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Fax | 918-825-6234
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Authorized Official
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Title or Position | DIRECTOR
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Name | RICK LANGKAMP
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Credential |
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Telephone | 918-825-6825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 265
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License Number State | OK
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