MEDICARE: VALIR OUTPATIENT CLINICS 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	:	1275713489
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALIR OUTPATIENT CLINICS LLC

Provider Business Mailing Address
First Line	:	825 N BROADWAY AVE
Second Line	:	SUITE 400
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73102-6039
Country	:	US
Telephone Number	:	405-609-3670
Fax Number	:	405-605-8638

Provider Business Practice Location Address
First Line	:	6904 E RENO AVE
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110-2152
Country	:	US
Telephone Number	:	405-610-2488
Fax Number	:	405-610-2484

Authorized Official
Title or Position	:	VP OF OUTPATIENT SERVICES
Name	:	MR. JOE A STREICH
Credential	:	MSPT
Telephone Number	:	405-609-3670

Provider Enumeration Date	:	11/06/2007
Last Update Date	:	11/06/2007

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