Provider Demographics
NPI:1952314577
Name:AMERICAN HOME MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:AMERICAN HOME MEDICAL SERVICES INC
Other - Org Name:MEDI-SERV HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-749-7774
Mailing Address - Street 1:1517 S HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-5821
Mailing Address - Country:US
Mailing Address - Phone:918-749-7774
Mailing Address - Fax:918-747-4920
Practice Address - Street 1:1517 S HARVARD AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74112-5821
Practice Address - Country:US
Practice Address - Phone:918-749-7774
Practice Address - Fax:918-747-4920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2D667332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100807730AMedicaid
OK=========OtherFEDERAL TAX ID
OK0215150002Medicare NSC