Gage Lucky 13 LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

GAGE LUCKY 13 LLC

Doing business as

Tecumseh Oxygen and Medical Supply

Practice address

503 N Broadway St
Tecumseh, OK 74873

Phone

(405) 598-0223

Fax

(405) 598-2833

NPI assigned

Apr 14, 2008

Last updated

Mar 25, 2009By 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. Nicole Gage

Title

Member/Owner

Phone

(405) 598-8629

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tecumseh Oxygen and Medical Supply 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": "1208131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237939200000",
    "number": "1982878724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 N BROADWAY ST",
            "city": "TECUMSEH",
            "state": "OK",
            "postal_code": "74873",
            "telephone_number": "405-598-0223",
            "fax_number": "405-598-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 N BROADWAY ST",
            "city": "TECUMSEH",
            "state": "OK",
            "postal_code": "74873",
            "telephone_number": "405-598-0223",
            "fax_number": "405-598-2833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAGE LUCKY 13 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-14",
        "last_updated": "2009-03-25",
        "status": "A",
        "authorized_official_last_name": "GAGE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "MEMBER/OWNER",
        "authorized_official_telephone_number": "405-598-8629",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200199380A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tecumseh Oxygen and Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kendra Fixico, PTA
• Cameron W Fletcher
• Haley N French
• Future Healthcare Services Inc (Sunset Estates of Tecumseh)
• Future Healthcare Services, Inc. (Tecumseh Sunset Estates)
• Richard Garcia Jr.
• Grayson Garvin
• Paul Gaspard
• Shayna Ann Gilbert
• Kaylee Michelle Gill

• Oxygen Equipment & Supplies (DME) in Tecumseh, OK
• Providers in Tecumseh, OK by specialty
• Oxygen Equipment & Supplies (DME) in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; 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.