Organization
TILLMAN COUNTY OKLAHOMA EMERGENCY
Active
Other names
Tillman County Emergency Medical Service Dist
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE L JOHNSON (OFFICE MANAGER)
(580) 335-5877
Entity
Organization
Contact information
Practice address
300 E LUCILLE AVE, FREDERICK, OK 73542-1422
(580) 335-5877
(580) 335-5512
Mailing address
300 E LUCILLE AVE, FREDERICK, OK 73542-1422
(580) 335-5877
(580) 335-5512
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
EMS115
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100818780A
—
OK
Enumeration date
08/31/2006
Last updated
01/19/2022
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