Organization Name: | LAVERNE AMBULANCE SERVICE |
NPI Number: | 1104829290 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAULINE HEINZ (DIRECTOR) |
Mailing Address: | 115 N Ohio Laverne |
State: | OK US |
Postal Code: | 73848 |
Phone Number: | 5809213930 |
Fax Number: | 5809213938 |
NPI Enumeration Date: | 05/23/2005 |
NPI Last Update Date: | 03/25/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3416L0300X |
License Number: | EMS118 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Transportation Services |
Taxonomy Classification: | Ambulance |
Taxonomy Specialization: | Land Transport |
Taxonomy Definition: |