Pruitt Co. of Ada, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PRUITT CO. OF ADA, INC

Doing business as

Pruitt Care

Practice address

402 E 12TH St
Ada, OK 74820-6602

Phone

(580) 332-3523

Fax

(580) 310-0730

NPI assigned

Nov 9, 2005

Organization subpart

No

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

Authorized official

Name

Tammy Pruitt Prentice

Title

Owner/Corporate Officer/Manager

Phone

(580) 332-3523

Specialties & licenses 1

Addresses

Other names 1

• PRUITT CARE Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1962483636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 N BROADWAY AVE",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748201110",
            "telephone_number": "580-332-3523",
            "fax_number": "580-310-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 E 12TH ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748206602",
            "telephone_number": "580-332-3523",
            "fax_number": "580-310-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUITT CO. OF ADA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "PRENTICE",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "PRUITT",
        "authorized_official_title_or_position": "OWNER/CORPORATE OFFICER/MANAGER",
        "authorized_official_telephone_number": "580-332-3523"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRUITT CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Claralice Putnam, M.ED., LPC
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• Durable Medical Equipment & Medical Supplies in Ada, OK
• Providers in Ada, 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 Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.