Organization
KIOWA COUNTY DISTRICT THREE EMERGENCY AMBULANCE ASSOCIATION
Active
Other names
Kiowa County District Three Emergency Ambulance Association
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALLAS RAY MCPHAIL (VICE PRESIDENT)
(580) 569-2778
Entity
Organization
Contact information
Practice address
206 SPRUCE STREET, MOUNTAIN PARK, OK 73559-0220
(580) 569-2908
(580) 569-2908
Mailing address
PO BOX 220, 206 SPRUCE STREET, MOUNTAIN PARK, OK 73559-0220
(580) 569-2908
(580) 569-2908
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
052
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100818890A
—
OK
01
—
590002665
RAILROAD MEDICARE
OK
01
—
892540001-001
BC/BS
OK
Enumeration date
12/13/2006
Last updated
01/27/2009
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