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General NPI Number Information
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NPI Number | 1740457464
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Entity Type | Organization
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Legal Business Name | ALS MEDICAL LLC
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 3903 W BROADWAY
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City | MUSKOGEE
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State | OK
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Zip | 74401-5071
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Country | US
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Telephone | 918-682-1505
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Fax | 918-686-1064
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Provider Business Mailing Address
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Address Line | 3903 W BROADWAY
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City | MUSKOGEE
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State | OK
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Zip | 74401-5071
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Country | US
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Telephone | 918-682-1505
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Fax | 918-686-1064
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Authorized Official
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Title or Position | MANAGER
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Name | BARRY WATSON
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Credential |
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Telephone | 918-682-1505
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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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