Provider Demographics
NPI:1114976115
Name:PREMIER MEDICAL INC.
Entity Type:Organization
Organization Name:PREMIER MEDICAL INC.
Other - Org Name:M & M MOBILITY AND MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT, SALES
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:GUTHRIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-392-5252
Mailing Address - Street 1:8303 E 81ST ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-8093
Mailing Address - Country:US
Mailing Address - Phone:911-839-2525
Mailing Address - Fax:918-392-5253
Practice Address - Street 1:8303 E 81ST ST
Practice Address - Street 2:SUITE E
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-8093
Practice Address - Country:US
Practice Address - Phone:911-839-2525
Practice Address - Fax:918-392-5253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
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
OK1310100001Medicare ID - Type UnspecifiedPROVIDER NUMBER