MEDICARE: DIMPLE MORGAN

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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1689005415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIMPLE MORGAN

Provider Business Mailing Address
First Line	:	8912 NE 10TH ST
Second Line	:	B
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110-7106
Country	:	US
Telephone Number	:	405-343-5291
Fax Number	:	405-732-0683

Provider Business Practice Location Address
First Line	:	8912 NE 10TH ST
Second Line	:	B
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110-7106
Country	:	US
Telephone Number	:	405-343-5291
Fax Number	:	405-732-0683

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2013
Last Update Date	:	12/04/2013

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Directions to “ DIMPLE MORGAN ” Practice Location

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