# PRUITT CO. OF ADA, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PRUITT CARE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962483636
- **Authorized official:** TAMMY PRUITT PRENTICE (OWNER/CORPORATE OFFICER/MANAGER)
- **Authorized official phone:** (580) 332-3523

## Contact information

- **Practice address:** 402 E 12TH ST, ADA, OK 74820-6602
- **Practice address phone:** (580) 332-3523
- **Practice address fax:** (580) 310-0730
- **Mailing address:** 3900 N BROADWAY AVE, ADA, OK 74820-1110
- **Mailing address phone:** (580) 332-3523
- **Mailing address fax:** (580) 310-0730

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 11/09/2005
- **Last updated:** 04/20/2008