MEDICARE: WADLEY'S EMS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	0384	OK

General Provider Information

NPI Number	:	1801895362
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WADLEY'S EMS INC

Provider Business Mailing Address
First Line	:	PO BOX 997
Second Line	:
City	:	PURCELL
State	:	OK
Zip	:	73080-0997
Country	:	US
Telephone Number	:	405-527-5555
Fax Number	:	405-527-9693

Provider Business Practice Location Address
First Line	:	400 W WASHINGTON ST
Second Line	:
City	:	PURCELL
State	:	OK
Zip	:	73080-4016
Country	:	US
Telephone Number	:	405-527-5555
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JACKIE L WADLEY
Credential	:
Telephone Number	:	405-527-5555

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	08/22/2020

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Directions to “WADLEY'S EMS INC ” Practice Location

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