MEDICARE: ACE MEDICAL HOME CARE 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	332BX2000X	Oxygen Equipment & Supplies (DME)	499711	OK

Other Identifiers

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

General Provider Information

NPI Number	:	1710983986
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACE MEDICAL HOME CARE INC.

Provider Business Mailing Address
First Line	:	13 S MAIN ST
Second Line	:
City	:	MCALESTER
State	:	OK
Zip	:	74501-5361
Country	:	US
Telephone Number	:	918-423-2700
Fax Number	:	918-423-6612

Provider Business Practice Location Address
First Line	:	13 S MAIN ST
Second Line	:
City	:	MCALESTER
State	:	OK
Zip	:	74501-5361
Country	:	US
Telephone Number	:	918-423-2700
Fax Number	:	918-423-6612

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. LANA LOUISE SUTER
Credential	:
Telephone Number	:	918-423-2700

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	02/02/2012

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Directions to “ACE MEDICAL HOME CARE INC. ” Practice Location

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