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General NPI Number Information
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NPI Number | 1376413278
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Entity Type | Organization
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Legal Business Name | GLACIER MEDICAL SUPPLY, INC.
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Dates
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Enumeration Date | 11/06/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 2300 S BROADWAY STE 109
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City | EDMOND
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State | OK
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Zip | 73013-4042
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Country | US
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Telephone | 405-816-6266
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 S BROADWAY STE 109
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City | EDMOND
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State | OK
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Zip | 73013-4042
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Country | US
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Telephone | 405-816-6266
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHAD EMERY HUFFMYER
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Credential |
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Telephone | 405-816-6266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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