Organization
SENIOR CARE MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT EDWARD STUDDARD (PRESIDENT)
(918) 756-1749
Entity
Organization
Contact information
Practice address
1001 E 20TH ST, OKMULGEE, OK 74447-6029
(918) 756-1749
(918) 756-1754
Mailing address
PO BOX 473, OKMULGEE, OK 74447-0473
(918) 756-1749
(918) 756-1754
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100811500
—
OK
01
—
731435468-001
BLUE CROSS BLUE SHIELD
OK
Enumeration date
09/07/2005
Last updated
06/19/2008
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