Organization
MTN. VIEW-GOTEBO AMBULANCE SERVICE
Active
Other names
Mountain View - Gotebo Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA LYNN DEMARCUS ADMINISTRATOR (ADMINISTRATOR)
(580) 347-2268
Entity
Organization
Contact information
Practice address
319 NORTH THIRD, MOUNTAIN VIEW, OK 73062-0294
(580) 347-2268
(580) 347-2268
Mailing address
BOX 294, MT. VIEW, OK 73062-0294
(580) 347-2268
(580) 347-2268
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
EMS104
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100818850A
—
OK
Enumeration date
05/27/2005
Last updated
11/22/2010
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