Healthcare Provider Details

I. General information

NPI: 1336466317
Provider Name (Legal Business Name): U.S. ALERT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2010
Last Update Date: 07/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22131 COUNTY ROAD 1560
STONEWALL OK
74871-6471
US

IV. Provider business mailing address

22131 COUNTY ROAD 1560
STONEWALL OK
74871-6471
US

V. Phone/Fax

Practice location:
  • Phone: 580-272-0303
  • Fax: 801-659-4116
Mailing address:
  • Phone: 580-272-0303
  • Fax: 801-659-4116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number774
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number774
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number774
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number774
License Number StateOK
# 5
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number774
License Number StateOK
# 6
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number774
License Number StateOK

VIII. Authorized Official

Name: JEREMY YOUNG
Title or Position: CEO/PRESIDENT
Credential:
Phone: 580-272-0303