Provider Demographics
NPI:1568664449
Name:TOWN OF KEYES OKLAHOMA
Entity Type:Organization
Organization Name:TOWN OF KEYES OKLAHOMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MOSER
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-B
Authorized Official - Phone:580-546-7270
Mailing Address - Street 1:PO BOX 121
Mailing Address - Street 2:106 E 3RD
Mailing Address - City:KEYES
Mailing Address - State:OK
Mailing Address - Zip Code:73947-0121
Mailing Address - Country:US
Mailing Address - Phone:580-546-7651
Mailing Address - Fax:580-546-7617
Practice Address - Street 1:106 E. 3RD
Practice Address - Street 2:
Practice Address - City:KEYES
Practice Address - State:OK
Practice Address - Zip Code:73947-0121
Practice Address - Country:US
Practice Address - Phone:580-546-7651
Practice Address - Fax:580-546-7617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKEMS347146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Multi-Specialty