1518223601 NPI number — BIO-MEDICAL APPLICATIONS OF OKLAHOMA, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518223601 NPI number — BIO-MEDICAL APPLICATIONS OF OKLAHOMA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BIO-MEDICAL APPLICATIONS OF OKLAHOMA, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518223601
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10205 N. 110TH EAST AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OWASSO
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74055-0000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-618-0248
Provider Business Mailing Address Fax Number:
918-683-3161

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10205 N. 110TH EAST AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OWASSO
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74055-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-618-0248
Provider Business Practice Location Address Fax Number:
918-683-3161
Provider Enumeration Date:
04/03/2012

Additional Information

Authorized Official

Authorized Official Last Name:
FAWCETT
Authorized Official First Name:
MARK
Authorized Official Middle Name:
R
Authorized Official Title or Position:
TREASURER
Authorized Official Telephone Number:
781-699-9000

Provider Taxonomy Codes

  • Taxonomy code: 261QE0700X , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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