Provider Demographics
NPI:1750384764
Name:CITY OF PERRY
Entity type:Organization
Organization Name:CITY OF PERRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HINCHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-336-9755
Mailing Address - Street 1:PO BOX 798
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:OK
Mailing Address - Zip Code:73077-0798
Mailing Address - Country:US
Mailing Address - Phone:580-336-4111
Mailing Address - Fax:580-336-4065
Practice Address - Street 1:732 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:OK
Practice Address - Zip Code:73077-6425
Practice Address - Country:US
Practice Address - Phone:580-336-4111
Practice Address - Fax:580-336-4065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKEMS0593416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========-001OtherBCBS PROVIDER #
OK=========-001OtherBCBS PROVIDER #