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General NPI Number Information
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NPI Number | 1497042766
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Entity Type | Organization
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Legal Business Name | OKTIVE HEALTHCARE
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 07/21/2011
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Provider Practice Location Address
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Address Line | 307 RICHEY DR
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City | VERONA
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State | PA
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Zip | 15147-3421
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Country | US
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Telephone | 412-259-3214
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Fax |
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Provider Business Mailing Address
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Address Line | 307 RICHEY DR
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City | VERONA
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State | PA
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Zip | 15147-3421
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Country | US
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Telephone | 412-259-3214
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. EVENS AUGUSTIN
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Credential |
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Telephone | 412-259-3214
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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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Taxonomy #2
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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