Greer County Special Ambulance Service District

Key facts

NPI

1023075736

Entity type

Organization (NPI type 2)

Primary specialty

Land Ambulance 3416L0300X

License

107EMS (OK)

Legal business name

GREER COUNTY SPECIAL AMBULANCE SERVICE DISTRICT

Practice address

121 E Jefferson St
Mangum, OK 73554-4242

Phone

(580) 782-5314

Fax

(580) 782-2648

NPI assigned

Apr 27, 2006

Organization subpart

No

Authorized official

Name

Mr. Michael Scott Augustine

Title

Administrator

Phone

(580) 782-5314

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

• Greer County Special Ambulance Service District Ambulance · Mangum, OK · NPI 1225307283
  NPD tax ID

Medicare participation

Medicare fee-for-service enrollment

Enrolled in OK

Medicare enrollment records

National Provider Directory

Tax ID family

Greer County Spec Ambul SRV (2 organizations share this tax ID)

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 19, 2012.

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334793600000",
    "number": "1023075736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 E JEFFERSON ST",
            "city": "MANGUM",
            "state": "OK",
            "postal_code": "735544242",
            "telephone_number": "580-782-5314",
            "fax_number": "580-782-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 E JEFFERSON ST",
            "city": "MANGUM",
            "state": "OK",
            "postal_code": "735544242",
            "telephone_number": "580-782-5314",
            "fax_number": "580-782-2648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREER COUNTY SPECIAL AMBULANCE SERVICE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2012-04-19",
        "status": "A",
        "authorized_official_last_name": "AUGUSTINE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "580-782-5314",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OK",
            "license": "107EMS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100820120A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mangum, OK

• Elmer Shane Folster, BSW
• Kara Garrett
• Sandra Gonzales
• Katrina Marie Grady
• Karri Green
• Greer County Special Ambulance Service District
• Holly Hamon
• Brittany Hand, DDS
• Shelia Annette Holmes, BA
• Keith D Hutton, BS

All providers in Mangum, OK · Land Ambulance in Oklahoma