MEDICARE: GERIATRIC MEDICAL SERVICES 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	261Q00000X	Clinic/Center	20328	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	800522004	OTHER	OK	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356373815
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GERIATRIC MEDICAL SERVICES INC.

Provider Business Mailing Address
First Line	:	PO BOX 19635
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73144-0635
Country	:	US
Telephone Number	:	405-692-2118
Fax Number	:	405-691-6499

Provider Business Practice Location Address
First Line	:	3545 NW 58TH ST STE 750
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4710
Country	:	US
Telephone Number	:	405-692-2118
Fax Number	:	405-691-6499

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. KERRY CRANMER
Credential	:	MD
Telephone Number	:	405-692-2118

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	10/31/2011

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