Provider Demographics
NPI:1093791865
Name:CITY OF CYRIL
Entity Type:Organization
Organization Name:CITY OF CYRIL
Other - Org Name:CYRIL AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANGER
Authorized Official - Prefix:
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-735-6342
Mailing Address - Street 1:PO BOX 448
Mailing Address - Street 2:
Mailing Address - City:CYRIL
Mailing Address - State:OK
Mailing Address - Zip Code:73029-0448
Mailing Address - Country:US
Mailing Address - Phone:580-464-2206
Mailing Address - Fax:580-464-2205
Practice Address - Street 1:202 W. MAIN
Practice Address - Street 2:
Practice Address - City:CYRIL
Practice Address - State:OK
Practice Address - Zip Code:73029
Practice Address - Country:US
Practice Address - Phone:580-464-2206
Practice Address - Fax:580-464-2205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100819720AMedicaid
OK441121466Medicare ID - Type Unspecified