Organization
OKLAHOMA ADVANTAGE STOREHOUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM LANCE MADISON (PRESIDENT)
(918) 306-1549
Entity
Organization
Contact information
Practice address
109 W MAPLE ST, FAIRFAX, OK 74637-1533
(918) 642-5492
(918) 601-2740
Mailing address
109 W MAPLE ST, FAIRFAX, OK 74637-1533
(918) 642-5492
(918) 601-2740
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/20/2017
Last updated
08/23/2023
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