Healthcare Provider Details

I. General information

NPI: 1427249762
Provider Name (Legal Business Name): CIMARRON RENTAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 03/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3620 S KELLY AVE
EDMOND OK
73013-3805
US

IV. Provider business mailing address

4412 N AIR DEPOT
EDMOND OK
73034-9518
US

V. Phone/Fax

Practice location:
  • Phone: 405-330-7908
  • Fax: 405-216-0041
Mailing address:
  • Phone: 405-330-7908
  • Fax: 405-216-0041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: LISA WALKER
Title or Position: BOOKKEEPER
Credential:
Phone: 405-330-7908