{
"Npi": {
"NPI": "1972656205",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CANTON-LONGDALE EMS DISTRICT",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 39",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CANTON",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "73724-0039",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "580-886-2515",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "#2 DEPOT RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CANTON",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "73724-0039",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "580-886-2515",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/19/2007",
"LastUpdateDate": "11/17/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SPRUNGER",
"AuthorizedOfficialFirstName": "CONNIE",
"AuthorizedOfficialMiddleName": "LEA",
"AuthorizedOfficialTitle": "OFFICE MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "580-886-2515",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "EMS111",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}