Organization Name: | KENMORE EYECARE CENTER |
NPI Number: | 1356524011 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TODD ALAN KENMORE (PRESIDENT) |
Mailing Address: | 513 N Telephone Rd Moore |
State: | OK US |
Postal Code: | 731604938 |
Phone Number: | 4057993030 |
Fax Number: | 4057993737 |
NPI Enumeration Date: | 12/17/2007 |
NPI Last Update Date: | 02/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 2366 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OK |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |