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General NPI Number Information
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NPI Number | 1447143482
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Entity Type | Organization
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Legal Business Name | MED-LINE, LLC
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 4133 NORTH LINCOLN BLVD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73105
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Country | US
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Telephone | 617-299-6398
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 904
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City | REDLANDS
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State | CA
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Zip | 92373
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EMPLOYEE
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Name | N AGRAWAL
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Credential |
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Telephone | 617-299-6398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2081P0301X
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Taxonomy Name | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2083C0008X
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Taxonomy Name | Clinical Informatics Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2084S0010X
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Taxonomy Name | Sports Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 246QL0900X
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Taxonomy Name | Laboratory Management Specialist/Technologist
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 246ZE0500X
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Taxonomy Name | EEG Specialist/Technologist
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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