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Organization
REVIVE DME
Active
Organization
REVIVE DME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM BLACK (OWNER)
(917) 769-2819
Entity
Organization
Contact information
Practice address
2525 NW EXPRESSWAY STE 208, OKLAHOMA CITY, OK 73112-7641
(405) 577-2266
Mailing address
2525 NW EXPRESSWAY STE 208, OKLAHOMA CITY, OK 73112-7641
(405) 577-2266
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
10/24/2024
Last updated
10/24/2024
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