Provider Demographics
NPI:1124197496
Name:AMBULANCE DISTRICT OF THE CRESCENT SCHOOL DISTRICT
Entity Type:Organization
Organization Name:AMBULANCE DISTRICT OF THE CRESCENT SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:405-969-2000
Mailing Address - Street 1:PO BOX 233
Mailing Address - Street 2:
Mailing Address - City:CRESCENT
Mailing Address - State:OK
Mailing Address - Zip Code:73028-0233
Mailing Address - Country:US
Mailing Address - Phone:405-969-2000
Mailing Address - Fax:405-969-2000
Practice Address - Street 1:120 W MONROE
Practice Address - Street 2:
Practice Address - City:CRESCENT
Practice Address - State:OK
Practice Address - Zip Code:73028
Practice Address - Country:US
Practice Address - Phone:405-969-2000
Practice Address - Fax:405-969-2000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKEMS1403416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport