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General NPI Number Information
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NPI Number | 1003602723
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Entity Type | Organization
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Legal Business Name | MED EQUIP DME LLC
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Dates
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Enumeration Date | 04/18/2025
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Last Update Date | 08/30/2025
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Provider Practice Location Address
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Address Line | 300 N 5TH ST STE A
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City | PONCA CITY
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State | OK
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Zip | 74601-4512
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Country | US
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Telephone | 580-762-1291
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Fax |
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Provider Business Mailing Address
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Address Line | 300 N 5TH ST STE A
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City | PONCA CITY
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State | OK
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Zip | 74601-4512
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Country | US
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Telephone | 580-762-1291
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | SCOTT T KIRKPATRICK
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Credential |
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Telephone | 918-808-7725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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