MEDICARE: THE COMPLIANCE RESOURCE GROUP, 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	291U00000X	Clinical Medical Laboratory	8149	OK

General Provider Information

NPI Number	:	1366764938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE COMPLIANCE RESOURCE GROUP, INC.

Provider Business Mailing Address
First Line	:	4800 NW 10TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73127-5816
Country	:	US
Telephone Number	:	405-943-6465
Fax Number	:	405-943-6460

Provider Business Practice Location Address
First Line	:	4800 NW 10TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73127-5816
Country	:	US
Telephone Number	:	405-943-6465
Fax Number	:	405-943-6460

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. JAMES C. TEDROW
Credential	:	MT(ASCP)
Telephone Number	:	405-943-6465

Provider Enumeration Date	:	02/23/2010
Last Update Date	:	02/23/2010

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