Provider Demographics
NPI:1740207646
Name:EMERGENCY MEDICAL SERVICES AUTHORITY
Entity Type:Organization
Organization Name:EMERGENCY MEDICAL SERVICES AUTHORITY
Other - Org Name:EMSA-EASTERN DIVISION
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:GAYLE
Authorized Official - Last Name:LEHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-812-9274
Mailing Address - Street 1:1417 N LANSING AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74106-5905
Mailing Address - Country:US
Mailing Address - Phone:918-596-3100
Mailing Address - Fax:918-596-3177
Practice Address - Street 1:1417 N LANSING AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-5905
Practice Address - Country:US
Practice Address - Phone:918-596-3100
Practice Address - Fax:918-596-3177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKEMS0443416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK235236500OtherUS DEPT OF LABOR/OWCP
OK590005555OtherRAILROAD MEDICARE
OK100818570AMedicaid
OK=========OtherHUMANA GOLD PLUS
OK=========-001OtherBCBS OF OK-FED EMP
OK=========OtherSTERLING LIFE
OK=========-001OtherBLUECHOICE
OK=========OtherCOMM CARE/STANDARD
OK=========OtherHUMANA GOLD PLUS