Organization
ELLIS COUNTY EMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE B LONGHOFER (BILLING COORDINATOR)
(580) 789-4512
Entity
Organization
Contact information
Practice address
1201 E 1ST, SHATTUCK, OK 73858-0591
(580) 789-4512
(580) 789-4512
Mailing address
PO BOX 591, SHATTUCK, OK 73858-0591
(580) 789-4512
(580) 789-4512
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
EMS042
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100818840A
—
OK
01
—
590002072
RAILROAD MEDICARE
OK
01
—
=========
BCBS PROVIDER #
OK
Enumeration date
05/23/2005
Last updated
11/19/2025
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