Provider Demographics
NPI:1851333561
Name:DENNIS VENTURES INC
Entity Type:Organization
Organization Name:DENNIS VENTURES INC
Other - Org Name:EQUIP CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-332-3353
Mailing Address - Street 1:15269 COUNTY ROAD 3610
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-1395
Mailing Address - Country:US
Mailing Address - Phone:580-332-3353
Mailing Address - Fax:580-332-3053
Practice Address - Street 1:439 N MONTE VISTA ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-4609
Practice Address - Country:US
Practice Address - Phone:580-332-3353
Practice Address - Fax:580-332-3053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
OK23-S-850332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100812950AMedicaid
OK=========002OtherBC/BS
OK4095050001Medicare ID - Type UnspecifiedMAIN LOCATION
OK4095050002Medicare ID - Type UnspecifiedSECOND LOCATION
OK4095050001Medicare NSC
OK100812950AMedicaid