Healthcare Provider Details

I. General information

NPI: 1285910844
Provider Name (Legal Business Name): PERFUSION ALLIANCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2011
Last Update Date: 10/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 N MAY AVE STE C
OKLAHOMA CITY OK
73112-6641
US

IV. Provider business mailing address

3601 N MAY AVE STE C
OKLAHOMA CITY OK
73112-6641
US

V. Phone/Fax

Practice location:
  • Phone: 405-604-5613
  • Fax: 405-601-3750
Mailing address:
  • Phone: 405-604-5613
  • Fax: 405-601-3750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code242T00000X
TaxonomyPerfusionist
License Number
License Number State

VIII. Authorized Official

Name: DEBRA J PARRISH
Title or Position: OFFICE MANAGER
Credential:
Phone: 405-604-5613