Provider Demographics
NPI:1033243415
Name:AMERICAN COMMUNICATION & REHABILITATION
Entity Type:Organization
Organization Name:AMERICAN COMMUNICATION & REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-607-0292
Mailing Address - Street 1:9 W 40TH ST
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-2735
Mailing Address - Country:US
Mailing Address - Phone:918-241-2110
Mailing Address - Fax:918-241-2112
Practice Address - Street 1:9 W 40TH ST
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-2735
Practice Address - Country:US
Practice Address - Phone:918-241-2110
Practice Address - Fax:918-241-2112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100796150CMedicaid
OK100796150EMedicaid
MO629736000Medicaid
OK100796150BMedicaid
OK100796150AMedicaid
OK100796150DMedicaid
KS200305120AMedicaid
OK100796150DMedicaid