=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487657177
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CITY OF MARSHALL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/27/2005
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 112 E MAIN
-----------------------------------------------------
City | MARSHALL
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73056
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 580-935-6785
-----------------------------------------------------
Fax | 405-969-2485
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 277
-----------------------------------------------------
City | MARSHALL
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73056-0277
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 580-935-6785
-----------------------------------------------------
Fax | 405-969-2485
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | JANIE TAYLOR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 580-935-6770
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | EMS177
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------