Organization
PROSOURCE MEDICAL EQUIPMENT AND SUPPLIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN RUSSELL WEBB (ADMINISTRATOR)
(888) 691-3237
Entity
Organization
Contact information
Practice address
6801 S EASTERN AVE, OKLAHOMA CITY, OK 73149-2300
(888) 691-3237
(405) 691-3395
Mailing address
6801 S EASTERN AVE, OKLAHOMA CITY, OK 73149-2300
(888) 691-3237
(405) 691-3395
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
117978
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100811900A
—
OK
Enumeration date
10/25/2005
Last updated
10/21/2010
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