Prime Source Dme of Oklahoma

NPI #1992079438 in Tulsa, Oklahoma

Provider Information

NPI Number: 1992079438
Entity Type: Organization
Organization Name: Prime Source Dme of Oklahoma
Primary Specialty: Durable Medical Equipment & Medical Supplies - Oxygen Equipment & Supplies
Enumeration Date: Mar 1, 2012
Last Updated: Mar 1, 2012

Practice Location

Address: 6810 E 40TH ST STE A
City: Tulsa
State: Oklahoma
ZIP Code: 74145-4510
Phone: (918) 935-2088

Authorized Official

Name: DONNA WALLACE
Title: ADMINISTRATION MANAGER
Phone: (918) 935-2088

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies - Oxygen Equipment & Supplies — Oxygen Equipment & Supplies	332BX2000X	Primary

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