Provider Demographics
NPI:1346512399
Name:COUNTRY CORNER FIRE DISTRICT INC
Entity Type:Organization
Organization Name:COUNTRY CORNER FIRE DISTRICT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:M
Authorized Official - Last Name:MASSEY
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:918-695-7323
Mailing Address - Street 1:6983 W 113TH ST N
Mailing Address - Street 2:
Mailing Address - City:SPERRY
Mailing Address - State:OK
Mailing Address - Zip Code:74073-4008
Mailing Address - Country:US
Mailing Address - Phone:918-695-7323
Mailing Address - Fax:
Practice Address - Street 1:6983 W 113TH ST N
Practice Address - Street 2:
Practice Address - City:SPERRY
Practice Address - State:OK
Practice Address - Zip Code:74073-4008
Practice Address - Country:US
Practice Address - Phone:918-695-7323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKEMS4623416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport