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General NPI Number Information
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NPI Number | 1710091269
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Entity Type | Organization
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Legal Business Name | CITY OF ERICK
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 10/27/2010
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Provider Practice Location Address
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Address Line | 415 E ROGER MILLER
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City | ERICK
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State | OK
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Zip | 73645-0025
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Country | US
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Telephone | 580-526-3924
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Fax | 580-526-3830
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Provider Business Mailing Address
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Address Line | PO BOX 25 206 S SHEB WOOLEY
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City | ERICK
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State | OK
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Zip | 73645-0025
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Country | US
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Telephone | 580-526-3924
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Fax | 580-526-3830
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Authorized Official
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Title or Position | EMT
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Name | ELIZABETH MARIE FORGAY
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Credential |
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Telephone | 580-526-3924
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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 | EMS034
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License Number State | OK
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