Provider Demographics
NPI:1316923709
Name:RUSH SPRINGS EMS
Entity type:Organization
Organization Name:RUSH SPRINGS EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER RSEMS
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:TRUSTY
Authorized Official - Suffix:
Authorized Official - Credentials:NATIONALLY REGISTERE
Authorized Official - Phone:580-476-6438
Mailing Address - Street 1:PO BOX 708
Mailing Address - Street 2:
Mailing Address - City:RUSH SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:73082-0708
Mailing Address - Country:US
Mailing Address - Phone:580-476-3438
Mailing Address - Fax:
Practice Address - Street 1:201 W BLAKELY
Practice Address - Street 2:
Practice Address - City:RUSH SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:73082
Practice Address - Country:US
Practice Address - Phone:580-476-3438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-19
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100819060AMedicaid
OKOKB5102Medicare PIN