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General NPI Number Information
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NPI Number | 1649463704
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Entity Type | Organization
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Legal Business Name | CENTURY MEDICAL LLC
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Dates
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Enumeration Date | 08/22/2007
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 3601 S BROADWAY STE 500
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City | EDMOND
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State | OK
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Zip | 73013-4140
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Country | US
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Telephone | 405-286-1100
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Fax | 405-286-6207
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Provider Business Mailing Address
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Address Line | 3601 S BROADWAY STE 500
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City | EDMOND
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State | OK
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Zip | 73013-4140
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Country | US
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Telephone | 405-286-1100
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Fax | 405-286-6207
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Authorized Official
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Title or Position | PRES CEO
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Name | MR. KELLY ALLEN WEST
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Credential | C. PED, CRT
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Telephone | 405-286-1100
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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 | 897705
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License Number State | OK
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