Healthcare Provider Details

I. General information

NPI: 1215035993
Provider Name (Legal Business Name): HOME TOWN MEDICAL SUPPLIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 12/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1137 SE 1083 AVENUE
RED OAK OK
74563
US

IV. Provider business mailing address

1137 SE 1083 AVENUE
RED OAK OK
74563
US

V. Phone/Fax

Practice location:
  • Phone: 918-465-4242
  • Fax: 918-465-4595
Mailing address:
  • Phone: 918-465-4242
  • Fax: 918-465-4595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MELANIE ZUBLIS
Title or Position: OWNER
Credential:
Phone: 918-465-4242