| Organization Name: | CITY OF WAGONER |
| NPI Number: | 1093890352 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES ROBERTS (SUPERVISOR) |
| Mailing Address: | 300 Se 3rd St Wagoner |
| State: | OK US |
| Postal Code: | 744675726 |
| Phone Number: | 8005388278 |
| Fax Number: | 5806282273 |
| NPI Enumeration Date: | 10/26/2006 |
| NPI Last Update Date: | 12/14/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | EMS014 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |