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General NPI Number Information
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NPI Number | 1336294099
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Entity Type | Organization
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Legal Business Name | CITY OF PICHER
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 02/24/2009
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Provider Practice Location Address
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Address Line | 213 CARL PATTERSON AVE
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City | PICHER
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State | OK
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Zip | 74360-1609
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Country | US
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Telephone | 918-673-1709
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Fax | 918-673-2724
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Provider Business Mailing Address
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Address Line | 101 N CONNELL AVE
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City | PICHER
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State | OK
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Zip | 74360-1505
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Country | US
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Telephone | 918-673-1709
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Fax | 918-673-2724
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Authorized Official
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Title or Position | EMS DIRECTOR
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Name | JEFF REEVES
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Credential |
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Telephone | 918-673-1709
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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 | 419
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License Number State | OK
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