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Organization

SHAMROCK, INC

Active
Parent organization
WACUKA INC
Other names
Medical Equipment Affilitates
Organization subpart
Yes

Provider details

NPI number
Legal business name
WACUKA INC
Authorized official
RANDY M TAYLOR (CEO/PRESIDENT)
(918) 456-4797
Entity
Organization

Contact information

Practice address
200 W CHOCTAW ST, TAHLEQUAH, OK 74464-3369
(918) 456-4797
(918) 456-8413
Mailing address
200 W CHOCTAW ST, TAHLEQUAH, OK 74464-3808
(918) 456-4797
(918) 456-8413

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100809610A
OK
Enumeration date
09/29/2006
Last updated
06/26/2023
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