Healthcare Provider Details

I. General information

NPI: 1497042766
Provider Name (Legal Business Name): OKTIVE HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2011
Last Update Date: 07/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 RICHEY DR
VERONA PA
15147-3421
US

IV. Provider business mailing address

307 RICHEY DR
VERONA PA
15147-3421
US

V. Phone/Fax

Practice location:
  • Phone: 412-259-3214
  • Fax:
Mailing address:
  • Phone: 412-259-3214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. EVENS AUGUSTIN
Title or Position: PRESIDENT
Credential:
Phone: 412-259-3214