Provider Demographics
NPI:1275657041
Name:SHAPEMASTER USA, INC.
Entity Type:Organization
Organization Name:SHAPEMASTER USA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:TIPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-392-3475
Mailing Address - Street 1:7335 S. LEWIS AVE.
Mailing Address - Street 2:SUITE 308
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136
Mailing Address - Country:US
Mailing Address - Phone:918-392-3475
Mailing Address - Fax:918-392-3471
Practice Address - Street 1:7335 SOUTH LEWIS AVE.
Practice Address - Street 2:SUITE 308
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-6897
Practice Address - Country:US
Practice Address - Phone:918-392-3475
Practice Address - Fax:918-392-3471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2008-08-01
Deactivation Date:2007-09-11
Deactivation Code:
Reactivation Date:2008-01-31
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies