NPI: 1891241642 · PRAGUE, OK 74864 · Land Ambulance · NPI assigned 08/31/2016
| Authorized Official | WITTEN, DIANA (VICE PRESIDENT) |
| NPI Enumeration Date | 08/31/2016 |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 12 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 12 | 12 | $2K |