Provider Demographics
NPI:1831443969
Name:BRYAN COUNTY EMS
Entity type:Organization
Organization Name:BRYAN COUNTY EMS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DEPUTY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:NORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-924-4687
Mailing Address - Street 1:POST OFFICE BOX 1
Mailing Address - Street 2:306 SOUTH 22ND AVENUE
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-0001
Mailing Address - Country:US
Mailing Address - Phone:580-924-4687
Mailing Address - Fax:580-924-4688
Practice Address - Street 1:306 S 22ND AVE
Practice Address - Street 2:POST OFFICE BOX 1
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-5647
Practice Address - Country:US
Practice Address - Phone:580-924-4687
Practice Address - Fax:580-924-4688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK128146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty