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General NPI Number Information
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NPI Number | 1497905731
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Entity Type | Organization
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Legal Business Name | ALTUS MEDICAL EQUIPMENT
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Dates
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Enumeration Date | 09/23/2008
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Last Update Date | 09/23/2008
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Provider Practice Location Address
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Address Line | 1009 E SUTHERLAND ST
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City | ALTUS
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State | OK
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Zip | 73521-4046
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Country | US
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Telephone | 580-301-0828
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Fax | 580-482-4648
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Provider Business Mailing Address
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Address Line | 1009 E SUTHERLAND ST
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City | ALTUS
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State | OK
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Zip | 73521-4046
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Country | US
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Telephone | 580-301-0828
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Fax | 580-482-4648
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Authorized Official
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Title or Position | CEO-MANAGER
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Name | JOSH DRAKE III
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Credential |
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Telephone | 580-301-0828
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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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