Provider Demographics
NPI:1568560969
Name:CITY OF CHANDLER
Entity Type:Organization
Organization Name:CITY OF CHANDLER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. FIRE CHIEF / EMS SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUCHANAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-258-3207
Mailing Address - Street 1:220 S CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:OK
Mailing Address - Zip Code:74834-2242
Mailing Address - Country:US
Mailing Address - Phone:405-258-3207
Mailing Address - Fax:405-258-0698
Practice Address - Street 1:220 S CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:OK
Practice Address - Zip Code:74834-2242
Practice Address - Country:US
Practice Address - Phone:800-538-8278
Practice Address - Fax:580-628-2273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK960323416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100819650AMedicaid
OK=========001OtherBCBS PROVIDER NUMBER
=========Medicare PIN