Prime Source DME of Oklahoma

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

PRIME SOURCE DME OF OKLAHOMA

Practice address

6810 E 40TH St Ste a
Tulsa, OK 74145-4510

Phone

(918) 935-2088

Fax

(918) 935-2087

NPI assigned

Mar 1, 2012

Organization subpart

No

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

Authorized official

Name

Donna Wallace

Title

Administration Manager

Phone

(918) 935-2088

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330560000000",
    "number": "1992079438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 E 40TH ST STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741454510",
            "telephone_number": "918-935-2088",
            "fax_number": "918-935-2087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6810 E 40TH ST STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741454510",
            "telephone_number": "918-935-2088",
            "fax_number": "918-935-2087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME SOURCE DME OF OKLAHOMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-01",
        "last_updated": "2012-03-01",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "ADMINISTRATION MANAGER",
        "authorized_official_telephone_number": "918-935-2088"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Primary Care at Home LLC
• Primary Care of Tulsa
• Primary Care Physicians of Tulsa Region PC
• Prime Care Tulsa, LLC
• Prime Medical Group Corp
• Andrew Prince, D.O.
• Heidi Prince, D.O.
• Larry O Prince, DDS
• Praise J Prince
• Sheila Prince

• Oxygen Equipment & Supplies (DME) in Tulsa, OK
• Providers in Tulsa, 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 1, 2012; 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.