Provider Demographics
NPI:1417175878
Name:HOME THERAPY EQUIPMENT INC
Entity Type:Organization
Organization Name:HOME THERAPY EQUIPMENT INC
Other - Org Name:THE FITTING ROOM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:PRUETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-582-1976
Mailing Address - Street 1:PO BOX 14270
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74159-1270
Mailing Address - Country:US
Mailing Address - Phone:918-582-1975
Mailing Address - Fax:918-584-1976
Practice Address - Street 1:1120 S UTICA AVE
Practice Address - Street 2:HILLCREST CHAPMAN BREAST CENTER
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4012
Practice Address - Country:US
Practice Address - Phone:918-582-1975
Practice Address - Fax:918-584-1976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100809560AMedicaid
OK0426200002Medicare ID - Type Unspecified