Provider Demographics
NPI:1891821229
Name:BUFFALO EMERGENCY MEDICAL SERVICE DISTRICT
Entity Type:Organization
Organization Name:BUFFALO EMERGENCY MEDICAL SERVICE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:580-727-5421
Mailing Address - Street 1:1005 NORTH HOY
Mailing Address - Street 2:PO BOX 676
Mailing Address - City:BUFFALO
Mailing Address - State:OK
Mailing Address - Zip Code:73834-0676
Mailing Address - Country:US
Mailing Address - Phone:580-735-2828
Mailing Address - Fax:580-735-2828
Practice Address - Street 1:1005 NORTH HOY
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:OK
Practice Address - Zip Code:73834-0676
Practice Address - Country:US
Practice Address - Phone:580-735-2828
Practice Address - Fax:580-735-2828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2553416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========Medicare ID - Type Unspecified