Organization
LAVERNE AMBULANCE SERVICE
Active
Other names
Laverne EMS
Organization subpart
No
Provider details
NPI number
Authorized official
PAULINE HEINZ (DIRECTOR)
(580) 921-3930
Entity
Organization
Contact information
Practice address
115 N OHIO, LAVERNE, OK 73848
(580) 921-3930
(580) 921-3938
Mailing address
PO BOX 902, LAVERNE, OK 73848-0902
(580) 921-3930
(580) 921-3938
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
EMS118
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100818790A
—
OK
01
—
P00151922
RAILROAD MEDICARE
OK
Enumeration date
05/23/2005
Last updated
03/25/2009
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