Provider Demographics
NPI:1033283452
Name:VISIONQUEST INC
Entity Type:Organization
Organization Name:VISIONQUEST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:FLOWERETTE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:918-287-1400
Mailing Address - Street 1:606 KIHEKAH AVE
Mailing Address - Street 2:
Mailing Address - City:PAWHUSKA
Mailing Address - State:OK
Mailing Address - Zip Code:74056-4225
Mailing Address - Country:US
Mailing Address - Phone:918-287-1400
Mailing Address - Fax:918-287-1814
Practice Address - Street 1:606 KIHEKAH AVE
Practice Address - Street 2:
Practice Address - City:PAWHUSKA
Practice Address - State:OK
Practice Address - Zip Code:74056-4225
Practice Address - Country:US
Practice Address - Phone:918-287-1400
Practice Address - Fax:918-287-1814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1336162601OtherDMES