Provider Demographics
NPI:1205901964
Name:VITAL SYSTEMS OF OKLAHOMA INC
Entity type:Organization
Organization Name:VITAL SYSTEMS OF OKLAHOMA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MNGR
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:
Authorized Official - Last Name:ANSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-376-9980
Mailing Address - Street 1:1218 E HIGHLINE LANE
Mailing Address - Street 2:
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-5133
Mailing Address - Country:US
Mailing Address - Phone:405-376-9980
Mailing Address - Fax:405-376-9981
Practice Address - Street 1:1218 E HIGHLINE LANE
Practice Address - Street 2:
Practice Address - City:MUSTANG
Practice Address - State:OK
Practice Address - Zip Code:73064-5133
Practice Address - Country:US
Practice Address - Phone:405-376-9980
Practice Address - Fax:405-376-9981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7470251F00000X
332B00000X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100812300AMedicaid
OK100812300BMedicaid
OK100812300BMedicaid