Organization
MERCY DIABETIC SUPPLY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EUNJA LEE VASQUEZ (OWNER/PRESIDENT)
(405) 242-5030
Entity
Organization
Contact information
Practice address
3140 W BRITTON RD, SUITE #201, OKLAHOMA CITY, OK 73120-2039
(405) 242-5030
(405) 242-5309
Mailing address
3140 W BRITTON RD, SUITE #201, OKLAHOMA CITY, OK 73120-2039
(405) 242-5030
(405) 242-5309
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
542611
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200286530A
—
OK
Enumeration date
08/06/2009
Last updated
10/25/2011
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