Greer County Special Ambulance Service District
Organization Active NPI Ambulance · Mangum, OK
NPI 1225307283 · NPPES record last updated Apr 6, 2012
Key facts
- NPI
- 1225307283
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- License
- 107 (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
- Dec 21, 2011
- Organization subpart
- No
Authorized official
- Name
- Michael Augustine
- Title
- Administrator
- Phone
- (580) 782-5314
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Greer County Spec Ambul SRV
Locations
121 E Jefferson St
Mangum, OK 73554
Phone (580) 782-5314
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 107 | OK | Yes |
Addresses
Primary practice location
121 E Jefferson St
Mangum, OK 73554-4242
Mailing address
121 E Jefferson St
Mangum, OK 73554-4242
Phone (580) 782-5314
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100820120A | Medicaid | OK |
Other providers in Mangum, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.