Organization
SOUTHWEST OKLAHOMA AMBULANCE AUTHORITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDDIE JAMES WATSON (DIRECTOR)
(580) 688-3363
Entity
Organization
Contact information
Practice address
1101 1/2 N 6TH, HOLLIS, OK 73550
(918) 313-7467
(580) 688-2289
Mailing address
PO BOX 88, HOLLIS, OK 73550-0088
(918) 313-7467
(580) 688-2289
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
EMS117
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100818690A
—
OK
01
—
590001072
RAILROAD MEDICARE
OK
01
—
=========
BCBS PROVIDER #
OK
Enumeration date
05/24/2005
Last updated
02/12/2025
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