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General NPI Number Information
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NPI Number | 1295072213
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Entity Type | Organization
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Legal Business Name | INFINITY HOME MEDICAL SUPPLY, LLC
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Dates
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Enumeration Date | 01/10/2013
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Last Update Date | 01/01/2015
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Provider Practice Location Address
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Address Line | 116 E 7TH AVE
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City | BRISTOW
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State | OK
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Zip | 74010-2502
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Country | US
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Telephone | 918-771-4460
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Fax | 918-513-7217
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Provider Business Mailing Address
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Address Line | 116 E 7TH AVE
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City | BRISTOW
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State | OK
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Zip | 74010-2502
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Country | US
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Telephone | 918-771-4460
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Fax | 918-513-7217
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MRS. HELEN CORALIE BROWN
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Credential |
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Telephone | 918-771-4460
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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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