Provider Demographics
NPI:1437684289
Name:PREMIER MEDICAL RENTAL CORP
Entity Type:Organization
Organization Name:PREMIER MEDICAL RENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-208-2020
Mailing Address - Street 1:2110 SE WASHINGTON ST STE A
Mailing Address - Street 2:
Mailing Address - City:IDABEL
Mailing Address - State:OK
Mailing Address - Zip Code:74745-5425
Mailing Address - Country:US
Mailing Address - Phone:580-208-2020
Mailing Address - Fax:580-208-2114
Practice Address - Street 1:2110 SE WASHINGTON ST STE A
Practice Address - Street 2:
Practice Address - City:IDABEL
Practice Address - State:OK
Practice Address - Zip Code:74745-5425
Practice Address - Country:US
Practice Address - Phone:580-208-2020
Practice Address - Fax:580-208-2114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-28
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies