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General NPI Number Information
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NPI Number | 1174850655
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Entity Type | Organization
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Legal Business Name | CRITICARE
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Dates
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Enumeration Date | 11/04/2009
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Last Update Date | 11/04/2009
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Provider Practice Location Address
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Address Line | 8202 E 116TH ST
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City | PERKINS
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State | OK
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Zip | 74059-3738
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Country | US
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Telephone | 405-269-2988
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 466
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City | PERKINS
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State | OK
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Zip | 74059-0466
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Country | US
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Telephone | 405-269-2988
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Fax |
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Authorized Official
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Title or Position | DIRECTOR / CRITICAL CARE PARAMEDIC
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Name | MICHAEL WILLIAMS
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Credential | CCEMT-P/FP-C
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Telephone | 405-269-3631
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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 | 448
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License Number State | OK
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