Provider Demographics
NPI:1609833615
Name:EMERGENCY CARE INC.
Entity Type:Organization
Organization Name:EMERGENCY CARE INC.
Other - Org Name:ECI
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR/CFO
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARR
Authorized Official - Suffix:JR
Authorized Official - Credentials:MBA
Authorized Official - Phone:918-665-1520
Mailing Address - Street 1:PO BOX 22063
Mailing Address - Street 2:DEPT 0491
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74121-2063
Mailing Address - Country:US
Mailing Address - Phone:405-751-4664
Mailing Address - Fax:405-749-4561
Practice Address - Street 1:6161 S YALE AVE
Practice Address - Street 2:ER DEPT.
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1902
Practice Address - Country:US
Practice Address - Phone:918-494-1817
Practice Address - Fax:405-749-4561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100730050CMedicaid
OK602880700OtherDEPT OF LABOR
OK100730050BMedicaid
OK100730050AMedicaid
OK=========001OtherBLUE CROSS & BLUE SHIELD
OK400522564Medicare PIN
OK100730050CMedicaid