Provider Demographics
NPI:1568561215
Name:CHEYENNE-ARAPAHO TRIBES OF OKLAHOMA
Entity Type:Organization
Organization Name:CHEYENNE-ARAPAHO TRIBES OF OKLAHOMA
Other - Org Name:CHEYENNE ARAPAHO EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AMBULANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-323-7087
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:CONCHO
Mailing Address - State:OK
Mailing Address - Zip Code:73022-0008
Mailing Address - Country:US
Mailing Address - Phone:800-538-8278
Mailing Address - Fax:580-628-2273
Practice Address - Street 1:RR 1 BOX 3054
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:OK
Practice Address - Zip Code:73601-9354
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:2006-09-21
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKEMS2133416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100818080AMedicaid
OK=========-001OtherBCBS PROVIDER NUMBER
OK=========-001OtherBCBS PROVIDER NUMBER