1720212533 NPI number — GREAT PLAINS MEDICAL EQUIPMENT PROVIDERS, INC.

Table of content: (NPI 1720212533)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720212533 NPI number — GREAT PLAINS MEDICAL EQUIPMENT PROVIDERS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GREAT PLAINS MEDICAL EQUIPMENT PROVIDERS, 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:
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:
1720212533
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/07/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12518 S 3RD CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JENKS
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74037-3383
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-331-5841
Provider Business Mailing Address Fax Number:
918-398-8195

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11855 N 207TH EAST AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLAREMORE
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74019-1991
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-283-2787
Provider Business Practice Location Address Fax Number:
918-398-8195
Provider Enumeration Date:
05/07/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SHEETS
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
DEAN
Authorized Official Title or Position:
VICE-PRESIDENT
Authorized Official Telephone Number:
866-331-5841

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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