institution
Shawnee Pedorthic Service, Inc.
Customized Equipment (DME) in Shawnee, Oklahoma
NPI 1922106509

Shawnee Pedorthic Service, Inc. is a Customized Equipment (DME) based in Shawnee, OK and is specialized in Customized Equipment. Shawnee Pedorthic Service, Inc. practices in Shawnee, OK. The NPI Number for Shawnee Pedorthic Service, Inc. is 1922106509 and holds a License No. 16 (Oklahoma).

The current practice location address for Shawnee Pedorthic Service, Inc. is 1510 N Kickapoo Ave, Shawnee, OK and can be reached out via phone at 405-275-1996 and via fax at 405-275-0809.

Location: 1510 N Kickapoo Ave, Shawnee, OK, 74804-4331
institution
Provider Profile Details
NPI Number
1922106509
Provider Name
Shawnee Pedorthic Service, Inc.
Credential
Provider Entity Type
Organization
Address
1510 N Kickapoo Ave, Shawnee, OK, 74804-4331
Phone Number
405-275-1996
Fax Number
405-275-0809
Provider Enumeration Date
09/20/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100808590 A 05 OK
731580812001 01 OK BLUECROSS BLUESHIELD PIN
institution
Provider Business Practice Location Address Details
Address
1510 N Kickapoo Ave
City
State
Zip
74804-4331
Phone Number
405-275-1996
Fax Number
405-275-0809
person
Provider Business Mailing Address Details
Address
1510 N Kickapoo Ave
City
State
Zip
74804-4331
Phone Number
405-275-1996
Fax Number
405-275-0809
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
Customized Equipment
Taxonomy
License No.
16 (Oklahoma)
Definition
Definition to come...
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