Muskogee County Emergency Medical Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

EMS078 Issued in OK

Legal business name

MUSKOGEE COUNTY EMERGENCY MEDICAL SERVICE

Practice address

200 Callahan St
Muskogee, OK 74403-5126

Phone

(918) 683-0130

Fax

(918) 683-9351

NPI assigned

May 27, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Laurel Havens, EMT-P

Title

Executive Director

Phone

(918) 683-0130

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652054400000",
    "number": "1366499121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CALLAHAN ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744035126",
            "telephone_number": "918-683-0130",
            "fax_number": "918-683-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CALLAHAN ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744035126",
            "telephone_number": "918-683-0130",
            "fax_number": "918-683-9351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSKOGEE COUNTY EMERGENCY MEDICAL SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A",
        "authorized_official_last_name": "HAVENS",
        "authorized_official_first_name": "LAUREL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "918-683-0130",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "EMT-P"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OK",
            "license": "EMS078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590001059",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100820180A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Muskogee Cancer Clinic Inc PC
• Muskogee Chiropractic Hand & Foot Clinic, LLC
• Muskogee Community Hospital LLC
• Muskogee County Council of Youth Service
• Muskogee County Council of Youth Services
• Muskogee Dental and Implants LLC
• Muskogee Dental Group, Inc.
• Muskogee Diagnostic Imaging
• Muskogee Dialysis LLC
• Muskogee Digestive Center Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.