Provider Demographics
NPI:1194016238
Name:DEPENDABLE HOME MEDICAL SUPPLIES, LLC
Entity Type:Organization
Organization Name:DEPENDABLE HOME MEDICAL SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TOMMY
Authorized Official - Middle Name:W
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-414-0606
Mailing Address - Street 1:413 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STROUD
Mailing Address - State:OK
Mailing Address - Zip Code:74079-3613
Mailing Address - Country:US
Mailing Address - Phone:918-968-9999
Mailing Address - Fax:918-968-9999
Practice Address - Street 1:413 W MAIN ST
Practice Address - Street 2:
Practice Address - City:STROUD
Practice Address - State:OK
Practice Address - Zip Code:74079-3613
Practice Address - Country:US
Practice Address - Phone:918-968-9999
Practice Address - Fax:918-968-9999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-24
Last Update Date:2011-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies