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Innovative Medical Supply, Llc
Durable Medical Equipment & Medical Supplies in Moore, Oklahoma
NPI 1679570121

Innovative Medical Supply, Llc is a Durable Medical Equipment & Medical Supplies based in Moore, OK. Innovative Medical Supply, Llc practices in Moore, OK. The NPI Number for Innovative Medical Supply, Llc is 1679570121 and holds a License No. (Oklahoma).

The current practice location address for Innovative Medical Supply, Llc is 1501 Se 4Th St, Moore, OK and can be reached out via phone at 405-799-8855 and via fax at 405-799-8860.

Location: 1501 Se 4Th St, Moore, OK, 73160-8231
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1679570121
Provider Name
Innovative Medical Supply, Llc
Credential
Provider Entity Type
Organization
Address
1501 Se 4Th St, Moore, OK, 73160-8231
Phone Number
405-799-8855
Fax Number
405-799-8860
Provider Enumeration Date
06/30/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2023000A 05 OK
209078400 01 OK DEPT OF LABOR PROVIDER #
20536475001 01 OK TRICARE PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
1501 Se 4Th St
City
Moore
State
Oklahoma
Zip
73160-8231
Phone Number
405-799-8855
Fax Number
405-799-8860
person
Provider Business Mailing Address Details
Address
1501 Se 4Th St
City
Moore
State
Oklahoma
Zip
73160-8231
Phone Number
405-799-8855
Fax Number
405-799-8860
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
332B00000X
License No.
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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's use in the home and that are usable for an extended period of time.
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