Organization
CARESOURCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY PIERCE (EXECUTIVE DIRECTOR)
(405) 948-2822
Entity
Organization
Contact information
Practice address
4350 WILL ROGERS PKWY, OKLAHOMA CITY, OK 73108-1826
(405) 948-2822
(405) 948-2811
Mailing address
PO BOX 270214, OKLAHOMA CITY, OK 73137-0214
(405) 948-2822
(405) 948-2811
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100808040A
—
OK
Enumeration date
10/19/2005
Last updated
07/21/2022
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