Power Shop

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

103TC1900X Issued in OK

Legal business name

POWER SHOP

Practice address

2103 W Beech Ave
Duncan, OK 73533-2334

Phone

(580) 252-4516

Fax

(580) 252-6903

NPI assigned

Sep 6, 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

Mike Patrick

Title

Executive Director

Phone

(580) 252-4516

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528161833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 W BEECH AVE",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735332334",
            "telephone_number": "580-252-4516",
            "fax_number": "580-252-6903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 W BEECH AVE",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735332334",
            "telephone_number": "580-252-4516",
            "fax_number": "580-252-6903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWER SHOP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PATRICK",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "580-252-4516"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "OK",
            "license": "103TC1900X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Duncan, OK
• Providers in Duncan, OK by specialty
• Developmentally Disabled Services Day Training Agency 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.