Edmond Wheelchair Repair & Supply, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

189873 Issued in OK

Legal business name

EDMOND WHEELCHAIR REPAIR & SUPPLY, LLC

Practice address

1608 Apian Way
Edmond, OK 73003-3916

Phone

(405) 348-7923

Fax

(405) 359-5006

NPI assigned

Nov 14, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Lavonne Mae Niemczyk

Title

Owner

Phone

(405) 348-7923

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023180411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 APIAN WAY",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730033916",
            "telephone_number": "405-348-7923",
            "fax_number": "405-359-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 APIAN WAY",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730033916",
            "telephone_number": "405-348-7923",
            "fax_number": "405-359-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMOND WHEELCHAIR REPAIR & SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NIEMCZYK",
        "authorized_official_first_name": "LAVONNE",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-348-7923",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OK",
            "license": "189873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Edmond, OK
• Providers in Edmond, OK by specialty
• Durable Medical Equipment & Medical Supplies in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.