Provider Demographics
NPI:1962599191
Name:CITY OF NEWKIRK
Entity type:Organization
Organization Name:CITY OF NEWKIRK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-362-3606
Mailing Address - Street 1:PO BOX 469
Mailing Address - Street 2:106 S MAPLE
Mailing Address - City:NEWKIRK
Mailing Address - State:OK
Mailing Address - Zip Code:74647-0469
Mailing Address - Country:US
Mailing Address - Phone:580-362-3606
Mailing Address - Fax:580-362-1131
Practice Address - Street 1:106 S MAPLE AVE
Practice Address - Street 2:106 S MAPLE
Practice Address - City:NEWKIRK
Practice Address - State:OK
Practice Address - Zip Code:74647-4025
Practice Address - Country:US
Practice Address - Phone:580-362-3606
Practice Address - Fax:580-362-1131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKEMS1083416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========Medicare ID - Type Unspecified