Organization
VISION SOURCE OF HUGO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINNY EDWARDS (OFFICE MANAGER)
(580) 326-3319
Entity
Organization
Contact information
Practice address
806 E JACKSON ST, HUGO, OK 74743-4222
(580) 326-3319
(580) 326-3310
Mailing address
806 E JACKSON ST, HUGO, OK 74743-4222
(580) 326-3319
(580) 326-3310
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2096
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
463471774-002
BLUE CROSS BLUESHIELD
OK
01
—
5836030001
PALMETTO GBA
OK
01
—
P00331640
RAILROAD MEDICARE
OK
Enumeration date
03/12/2007
Last updated
04/27/2010
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