Provider Demographics
NPI:1649416041
Name:MILLER EMS LLC
Entity Type:Organization
Organization Name:MILLER EMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:L
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-741-1233
Mailing Address - Street 1:PO BOX 65
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73759-0065
Mailing Address - Country:US
Mailing Address - Phone:580-741-1233
Mailing Address - Fax:580-395-2297
Practice Address - Street 1:514 N 1ST ST
Practice Address - Street 2:514 N 1ST STREET
Practice Address - City:MEDFORD
Practice Address - State:OK
Practice Address - Zip Code:73759-2421
Practice Address - Country:US
Practice Address - Phone:580-741-1233
Practice Address - Fax:580-395-2297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK436341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========OtherIRS DEPARTMENT OF THE TREASURY