Organization
ST. MARY'S PHYSICIAN ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD EVANS (VP)
(610) 768-3300
Entity
Organization
Contact information
Practice address
314 E OWEN K GARRIOTT RD, ENID, OK 73701-5712
(580) 249-3929
(580) 234-3301
Mailing address
PO BOX 3046, MALVERN, PA 19355-0746
(484) 913-7434
(484) 913-7587
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200111620M
—
OK
Enumeration date
02/04/2014
Last updated
06/28/2019
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