Organization
PROVISION MEDICAL SUPPLIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MASANGO (OWNER)
(405) 812-0833
Entity
Organization
Contact information
Practice address
1000 SW 44TH ST STE 200, OKLAHOMA CITY, OK 73109-3629
(405) 812-0833
Mailing address
1000 SW 44TH ST STE 200, OKLAHOMA CITY, OK 73109-3629
(405) 812-0833
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
12/04/2018
Last updated
12/04/2018
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