Organization
B & A MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY ALLEN WILSON SR. (PRESIDENT)
(580) 335-7334
Entity
Organization
Contact information
Practice address
301 N 13TH ST, FREDERICK, OK 73542-4405
(580) 335-7334
(580) 335-7445
Mailing address
PO BOX 946, 301 N 13TH ST, FREDERICK, OK 73542-0946
(580) 335-7334
(580) 335-7445
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
888623
OK
Other
Enumeration date
03/19/2007
Last updated
01/30/2008
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