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General NPI Number Information
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NPI Number | 1285593863
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Entity Type | Organization
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Legal Business Name | NEXIVA MEDICAL LLC
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 1217 N WASHINGTON AVE
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City | DURANT
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State | OK
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Zip | 74701-2119
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Country | US
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Telephone | 722-832-6894
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Fax |
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Provider Business Mailing Address
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Address Line | 1203 N WASHINGTON AVE
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City | DURANT
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State | OK
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Zip | 74701-2119
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Country | US
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Telephone | 307-459-0562
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Fax | 214-292-9630
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | LOUIS HANDY
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Credential |
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Telephone | 307-459-0562
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BD1200X
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Taxonomy Name | Dialysis Equipment & Supplies (DME)
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License Number |
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License Number State |
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