MEDICARE: EDMOND HYPERBARICS, INC.

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	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1144471962
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDMOND HYPERBARICS, INC.

Provider Business Mailing Address
First Line	:	416 W 15TH ST
Second Line	:	BLDG 100, SUITE 100
City	:	EDMOND
State	:	OK
Zip	:	73013-3747
Country	:	US
Telephone Number	:	405-513-8186
Fax Number	:

Provider Business Practice Location Address
First Line	:	416 W 15TH ST
Second Line	:	BLDG 100, SUITE 100
City	:	EDMOND
State	:	OK
Zip	:	73013-3747
Country	:	US
Telephone Number	:	405-513-8186
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. VICKI JONES
Credential	:
Telephone Number	:	405-513-8186

Provider Enumeration Date	:	10/10/2008
Last Update Date	:	10/10/2008

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Directions to “EDMOND HYPERBARICS, INC. ” Practice Location

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