Provider Demographics
NPI:1609874072
Name:ALL SAINTS HOME MEDICAL LLC
Entity Type:Organization
Organization Name:ALL SAINTS HOME MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WEIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-624-4400
Mailing Address - Street 1:3218 S 79TH EAST AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-1316
Mailing Address - Country:US
Mailing Address - Phone:918-624-4400
Mailing Address - Fax:918-624-4401
Practice Address - Street 1:3218 S 79TH EAST AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-1316
Practice Address - Country:US
Practice Address - Phone:918-624-4400
Practice Address - Fax:918-624-4401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
OKN/A332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK18003OtherMEDICARE SUBMITTER
OK100807350AMedicaid
OK5474280001Medicare NSC