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General NPI Number Information
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NPI Number | 1407500507
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Entity Type | Organization
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Legal Business Name | ADAIR COUNTY EMS
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Dates
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Enumeration Date | 02/08/2022
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 4 E WALNUT ST
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City | STILWELL
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State | OK
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Zip | 74960-4003
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Country | US
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Telephone | 918-410-7161
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Fax | 580-628-2267
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Provider Business Mailing Address
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Address Line | PO BOX 169
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City | STILWELL
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State | OK
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Zip | 74960-0169
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Country | US
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Telephone | 918-410-0077
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Fax | 580-628-2267
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Authorized Official
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Title or Position | EMS DIRECTOR
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Name | LISA TIDWELL
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Credential |
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Telephone | 918-410-0077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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