Community Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

EMS179 Issued in OK

Legal business name

COMMUNITY AMBULANCE SERVICE

Practice address

106 W 2ND Street
Seiling, OK 73663-0811

Phone

(580) 922-4241

Fax

(580) 922-4241

NPI assigned

May 23, 2005

Last updated

Jan 6, 2020By 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

Mr. Michael Nichols

Title

Director

Phone

(580) 922-4211

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578268800000",
    "number": "1104829365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 811",
            "city": "SEILING",
            "state": "OK",
            "postal_code": "736630811",
            "telephone_number": "580-922-4241",
            "fax_number": "580-922-4954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 W 2ND STREET",
            "city": "SEILING",
            "state": "OK",
            "postal_code": "736630811",
            "telephone_number": "580-922-4241",
            "fax_number": "580-922-4241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "580-922-4211",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OK",
            "license": "EMS179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100818410A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Seiling, OK
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• Land Ambulance in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; 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.