Provider Demographics
NPI:1881687655
Name:CHOCTAW COUNTY AMBULANCE AUTHORITY
Entity Type:Organization
Organization Name:CHOCTAW COUNTY AMBULANCE AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-326-2634
Mailing Address - Street 1:PO BOX 567
Mailing Address - Street 2:
Mailing Address - City:HUGO
Mailing Address - State:OK
Mailing Address - Zip Code:74743-0567
Mailing Address - Country:US
Mailing Address - Phone:580-326-2634
Mailing Address - Fax:580-326-6199
Practice Address - Street 1:218 E JACKSON ST
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:OK
Practice Address - Zip Code:74743-4037
Practice Address - Country:US
Practice Address - Phone:580-326-2634
Practice Address - Fax:580-326-6199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKEMS2273416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100818990AMedicaid
OK100818990AMedicaid