Organization
LEEDEY AMBULANCE SERVICE
Active
Other names
Leedey Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH WOHL (DIRECTOR)
(580) 488-2101
Entity
Organization
Contact information
Practice address
401 S MAIN, LEEDEY, OK 73654
(580) 488-3812
(580) 488-2191
Mailing address
PO BOX 190, LEEDEY, OK 73654-0190
(580) 488-3812
(580) 488-2191
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
EMS113
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100818750A
—
OK
01
—
590007407
RAILROAD MEDICARE
OK
Enumeration date
05/26/2005
Last updated
03/25/2009
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