Provider Demographics
NPI:1336124957
Name:COMMUNITY MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:COMMUNITY MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-776-0033
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:SALLISAW
Mailing Address - State:OK
Mailing Address - Zip Code:74955-0009
Mailing Address - Country:US
Mailing Address - Phone:918-790-3000
Mailing Address - Fax:918-775-8536
Practice Address - Street 1:306 N MAPLE
Practice Address - Street 2:
Practice Address - City:SALLISAW
Practice Address - State:OK
Practice Address - Zip Code:74955-4648
Practice Address - Country:US
Practice Address - Phone:918-790-3000
Practice Address - Fax:918-775-8536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-07
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1103940001Medicare NSC