Healthcare Provider Details

I. General information

NPI: 1851734271
Provider Name (Legal Business Name): ALL SAINTS HOME MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2013
Last Update Date: 04/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3015 SE WASHINGTON BLVD
BARTLESVILLE OK
74006-7629
US

IV. Provider business mailing address

6600 S YALE AVE SUITE 400
TULSA OK
74136-3347
US

V. Phone/Fax

Practice location:
  • Phone: 918-333-5110
  • Fax: 918-333-5116
Mailing address:
  • Phone: 918-502-2727
  • Fax: 918-502-2720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT E SMITH
Title or Position: ADMINISTRATOR
Credential:
Phone: 918-494-8497