MEDICARE: ASBURY MEDICAL SUPPLY, 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	332B00000X	Durable Medical Equipment & Medical Supplies

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	:	1902832488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASBURY MEDICAL SUPPLY, LLC

Provider Business Mailing Address
First Line	:	3401 N MAY AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-6904
Country	:	US
Telephone Number	:	405-858-0097
Fax Number	:	405-858-0119

Provider Business Practice Location Address
First Line	:	3401 N MAY AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-6904
Country	:	US
Telephone Number	:	405-858-0097
Fax Number	:	405-858-0119

Authorized Official
Title or Position	:	PRESIDENT / OWNER
Name	:	STEVE ASBURY
Credential	:
Telephone Number	:	405-858-0097

Provider Enumeration Date	:	06/25/2006
Last Update Date	:	06/18/2009

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Directions to “ASBURY MEDICAL SUPPLY, LLC ” Practice Location

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