City of Guymon
Organization Active NPI Land Ambulance · Guymon, OK
NPI 1962583575 · NPPES record last updated Oct 17, 2012
Key facts
- NPI
- 1962583575
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- EMS173 (OK)
- Legal business name
- CITY OF GUYMON
- Practice address
- 219 NW 4TH St
Guymon, OK 73942-4708 - Phone
- (800) 538-8278
- Fax
- (580) 628-2273
- NPI assigned
- Oct 18, 2006
- Organization subpart
- No
Authorized official
- Name
- Grant Wadley
- Title
- EMS Director
- Phone
- (580) 338-5537
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120910000081 | OK | Part B Supplier - Ambulance Service Supplier | 3678721057 | Practice locations: Guymon, OK |
National Provider Directory
Locations
402 NE 24th St
Guymon, OK 73942
Phone (580) 338-5536
309 N Roosevelt St
Guymon, OK 73942
Phone (580) 338-5536
219 NW 4th St
Guymon, OK 73942
Phone (580) 338-3396
424 N Main St
Guymon, OK 73942
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | EMS173 | OK | Yes |
Addresses
Primary practice location
219 NW 4TH St
Guymon, OK 73942-4708
Mailing address
219 NW 4TH St
Guymon, OK 73942-4708
Phone (800) 538-8278
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100819780A | Medicaid | OK |
Other names
- Guymon Ambulance Service
Other providers in Guymon, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.