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NPI Code Detail

MEDICARE: PROVIDENCE MEDICAL EQUIPMED INC

MEDICARE: PROVIDENCE MEDICAL EQUIPMED 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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1982891255
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROVIDENCE MEDICAL EQUIPMED INC
Provider Business Mailing Address
First Line : 5501 NW EXPRESSWAY
Second Line : SUITE 5509
City : WARR ACRES
State : OK
Zip : 73132-5230
Country : US
Telephone Number : 405-605-2791
Fax Number : 405-605-2792
Provider Business Practice Location Address
First Line : 5501 NW EXPRESSWAY
Second Line : SUITE 5509
City : WARR ACRES
State : OK
Zip : 73132-5230
Country : US
Telephone Number : 405-605-2791
Fax Number : 405-605-2792
Authorized Official
Title or Position : PRESIDENT
Name : DR. EZECHUKWU JOSHUA OHAKA
Credential :
Telephone Number : 405-605-2791
Provider Enumeration Date : 10/01/2007
Last Update Date : 02/19/2008

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Directions to “PROVIDENCE MEDICAL EQUIPMED INC ” Practice Location

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