# GREER COUNTY SPECIAL AMBULANCE SERVICE DISTRICT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225307283
- **Authorized official:** MICHAEL AUGUSTINE (ADMINISTRATOR)
- **Authorized official phone:** (580) 782-5314

## Contact information

- **Practice address:** 121 E JEFFERSON ST, MANGUM, OK 73554-4242
- **Practice address phone:** (580) 782-5314
- **Practice address fax:** (580) 782-2648
- **Mailing address:** 121 E JEFFERSON ST, MANGUM, OK 73554-4242
- **Mailing address phone:** (580) 782-5314
- **Mailing address fax:** (580) 782-2648

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 107 | OK | Yes |

## Other

- **Enumeration date:** 12/21/2011
- **Last updated:** 04/06/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100820120A | — | OK |