Leedey Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

EMS113 Issued in OK

Legal business name

LEEDEY AMBULANCE SERVICE

Doing business as

Leedey Ambulance Service

Practice address

401 S Main
Leedey, OK 73654

Phone

(580) 488-3812

Fax

(580) 488-2191

NPI assigned

May 26, 2005

Last updated

Mar 25, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kenneth Wohl

Title

Director

Phone

(580) 488-2101

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Leedey Ambulance Service Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237939200000",
    "number": "1033112776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "LEEDEY",
            "state": "OK",
            "postal_code": "736540190",
            "telephone_number": "580-488-3812",
            "fax_number": "580-488-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S MAIN",
            "city": "LEEDEY",
            "state": "OK",
            "postal_code": "73654",
            "telephone_number": "580-488-3812",
            "fax_number": "580-488-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEEDEY AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-26",
        "last_updated": "2009-03-25",
        "status": "A",
        "authorized_official_last_name": "WOHL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "580-488-2101"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OK",
            "license": "EMS113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100818750A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590007407",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leedey Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leedey Drug Inc
• Leedey Public Works Authority (Leedey Nursing Center)
• Richard Lindell Pierce, DPH
• Reflections Counseling Services

• Land Ambulance in Leedey, OK
• Providers in Leedey, OK by specialty
• Land Ambulance in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.