Healthcare Provider Details

I. General information

NPI: 1801534805
Provider Name (Legal Business Name): PURMA BIOLOGICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2022
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 SW 89TH ST STE A2
OKLAHOMA CITY OK
73139-9355
US

IV. Provider business mailing address

801 SW 89TH ST STE A2
OKLAHOMA CITY OK
73139-9355
US

V. Phone/Fax

Practice location:
  • Phone: 405-900-5111
  • Fax: 405-400-2024
Mailing address:
  • Phone: 405-822-2830
  • Fax: 400-400-2024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QG0250X
TaxonomyGenetics Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SEIFOLLAH AZADI
Title or Position: CEO
Credential: PHD
Phone: 405-822-2830