Provider Demographics
NPI:1285636241
Name:RALEY MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:RALEY MEDICAL EQUIPMENT, INC.
Other - Org Name:LAPLANTE MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:RALEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-835-6381
Mailing Address - Street 1:2174 S SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74129-1002
Mailing Address - Country:US
Mailing Address - Phone:918-835-6381
Mailing Address - Fax:918-838-3171
Practice Address - Street 1:2174 S SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74129-1002
Practice Address - Country:US
Practice Address - Phone:918-835-6381
Practice Address - Fax:918-838-3171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-02
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
OK=========001OtherBLUE CROSS PROVIDER NUMBE
OK=========001OtherBLUE CROSS PROVIDER NUMBE