MEDICARE: DMEWORX LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1033761366
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DMEWORX LLC

Provider Business Mailing Address
First Line	:	PO BOX 12009
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73157-2009
Country	:	US
Telephone Number	:	405-412-4207
Fax Number	:	405-600-9118

Provider Business Practice Location Address
First Line	:	3114 NW 42ND ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-6224
Country	:	US
Telephone Number	:	405-625-0850
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ERIN SISCO
Credential	:
Telephone Number	:	405-412-4207

Provider Enumeration Date	:	07/16/2019
Last Update Date	:	07/16/2019

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