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General NPI Number Information
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NPI Number | 1891980249
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Entity Type | Organization
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Legal Business Name | RAMIC TULSA, LLC
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 09/10/2007
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Provider Practice Location Address
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Address Line | 7050 S YALE AVE SUITE 101
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City | TULSA
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State | OK
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Zip | 74136-5708
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Country | US
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Telephone | 918-496-1333
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Fax | 918-496-1914
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Provider Business Mailing Address
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Address Line | 100 PARAGON DR
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City | MONTVALE
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State | NJ
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Zip | 07645-1779
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Country | US
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Telephone | 201-573-8080
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Fax | 201-573-4629
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ANTHONY SHIPPAM
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Credential |
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Telephone | 302-472-9101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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