Provider Demographics
NPI:1497500094
Name:BRUGENHEMKE MEDICAL LLC
Entity type:Organization
Organization Name:BRUGENHEMKE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ZANE
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:BRUGENHEMKE
Authorized Official - Suffix:
Authorized Official - Credentials:ATC, LAT
Authorized Official - Phone:402-680-2746
Mailing Address - Street 1:2000 W DANFORTH RD STE 120
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-4688
Mailing Address - Country:US
Mailing Address - Phone:402-680-2746
Mailing Address - Fax:
Practice Address - Street 1:2000 W DANFORTH RD STE 120
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-4688
Practice Address - Country:US
Practice Address - Phone:402-680-2746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-18
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies