Provider Demographics
NPI:1205866449
Name:NEW FRONTIER MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:NEW FRONTIER MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-270-0221
Mailing Address - Street 1:3336 E 32ND ST STE 102
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-4448
Mailing Address - Country:US
Mailing Address - Phone:918-236-4600
Mailing Address - Fax:
Practice Address - Street 1:3336 E 32ND ST STE 102
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-4448
Practice Address - Country:US
Practice Address - Phone:918-236-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200080240AMedicaid
OK200080240AMedicaid