MEDICARE: ALL SAINTS HOME MEDICAL 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	332BX2000X	Oxygen Equipment & Supplies (DME)	N/A	OK
2	332B00000X	Durable Medical Equipment & Medical Supplies

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	18003	OTHER	OK	MEDICARE SUBMITTER

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	:	1609874072
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL SAINTS HOME MEDICAL LLC

Provider Business Mailing Address
First Line	:	5402 S 129TH EAST AVE STE D
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74134-6706
Country	:	US
Telephone Number	:	918-624-4400
Fax Number	:	918-624-4469

Provider Business Practice Location Address
First Line	:	5402 S 129TH EAST AVE STE D
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74134-6706
Country	:	US
Telephone Number	:	918-624-4400
Fax Number	:	918-624-4469

Authorized Official
Title or Position	:	SYSTEM DIRECTOR, OPERATIONS ASHME
Name	:	MR. BRAD MULLEN
Credential	:
Telephone Number	:	918-940-1605

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	06/30/2025

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Directions to “ALL SAINTS HOME MEDICAL LLC ” Practice Location

Language	Start Address	Practice Location

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