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General NPI Number Information
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NPI Number | 1689853319
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Entity Type | Organization
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Legal Business Name | CITY OF STILWELL
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 06/11/2010
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Provider Practice Location Address
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Address Line | 20 1/2 W. WALNUT
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City | STILWELL
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State | OK
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Zip | 74960
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Country | US
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Telephone | 918-696-7209
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Fax | 918-696-8745
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Provider Business Mailing Address
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Address Line | 503 W DIVISION
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City | STILWELL
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State | OK
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Zip | 74960
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Country | US
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Telephone | 918-696-7209
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Fax | 918-696-6209
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. KARIN MARIANNE KETCHER
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Credential |
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Telephone | 918-696-6443
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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 | OK
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | EMS095
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License Number State | OK
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