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
1	332BN1400X	Nursing Facility Supplies (DME)
2	332BX2000X	Oxygen Equipment & Supplies (DME)
3	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
4	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1851734271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL SAINTS HOME MEDICAL, LLC

Provider Business Mailing Address
First Line	:	6600 S YALE AVE
Second Line	:	SUITE 400
City	:	TULSA
State	:	OK
Zip	:	74136-3347
Country	:	US
Telephone Number	:	918-502-2727
Fax Number	:	918-502-2720

Provider Business Practice Location Address
First Line	:	3015 SE WASHINGTON BLVD
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-7629
Country	:	US
Telephone Number	:	918-333-5110
Fax Number	:	918-333-5116

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. ROBERT E SMITH
Credential	:
Telephone Number	:	918-494-8497

Provider Enumeration Date	:	04/16/2013
Last Update Date	:	04/17/2013

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