Organization Name: | ST. MARY'S PHYSICIAN ASSOCIATES, LLC |
NPI Number: | 1740603265 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN JOHANNESSEN (VICE PRESIDENT) |
Mailing Address: | 314 E Owen K Garriott Rd Enid |
State: | OK US |
Postal Code: | 737015712 |
Phone Number: | 5802493929 |
Fax Number: | 5802343301 |
NPI Enumeration Date: | 02/04/2014 |
NPI Last Update Date: | 03/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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 |