Provider Demographics
NPI:1174735088
Name:INTEGRITY EMERGENCY MEDICAL SERVICES OF OKLAHOMA LLC
Entity type:Organization
Organization Name:INTEGRITY EMERGENCY MEDICAL SERVICES OF OKLAHOMA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BRONSON
Authorized Official - Suffix:
Authorized Official - Credentials:MED,EMT-P
Authorized Official - Phone:918-449-1335
Mailing Address - Street 1:PO BOX 365
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:OK
Mailing Address - Zip Code:74331-0365
Mailing Address - Country:US
Mailing Address - Phone:918-257-4352
Mailing Address - Fax:918-449-1336
Practice Address - Street 1:104 SW 1ST STREET
Practice Address - Street 2:
Practice Address - City:AFTON
Practice Address - State:OK
Practice Address - Zip Code:74331
Practice Address - Country:US
Practice Address - Phone:918-257-4352
Practice Address - Fax:918-449-1336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKEMS3883416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200129440AMedicaid
OK68064171001OtherBC/BS FO OKLAHOMA
OK200129440AMedicaid
OK68064171001OtherBC/BS FO OKLAHOMA