MEDICARE: RALEY MEDICAL EQUIPMENT, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1285636241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RALEY MEDICAL EQUIPMENT, INC.

Provider Business Mailing Address
First Line	:	2174 S SHERIDAN RD
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74129-1002
Country	:	US
Telephone Number	:	918-835-6381
Fax Number	:	918-838-3171

Provider Business Practice Location Address
First Line	:	2174 S SHERIDAN RD
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74129-1002
Country	:	US
Telephone Number	:	918-835-6381
Fax Number	:	918-838-3171

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. KEVIN BRUCE RALEY
Credential	:
Telephone Number	:	918-835-6381

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	08/22/2020

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