Healthcare Provider Details

I. General information

NPI: 1518678986
Provider Name (Legal Business Name): ZOOM MOBILE MED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2022
Last Update Date: 12/07/2022
Certification Date: 12/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6816 NW 63RD ST
BETHANY OK
73008
US

IV. Provider business mailing address

6816 NW 63RD ST
BETHANY OK
73008
US

V. Phone/Fax

Practice location:
  • Phone: 405-550-9884
  • Fax: 405-785-3773
Mailing address:
  • Phone: 405-550-9884
  • Fax: 405-785-3773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MS. BARBIE Y BARNETT
Title or Position: OWNER/DON
Credential:
Phone: 405-824-7643