Organization
GAGE LUCKY 13 LLC
Active
Other names
Tecumseh Oxygen and Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE GAGE (MEMBER/OWNER)
(405) 598-8629
Entity
Organization
Contact information
Practice address
503 N BROADWAY ST, TECUMSEH, OK 74873
(405) 598-0223
(405) 598-2833
Mailing address
503 N BROADWAY ST, TECUMSEH, OK 74873
(405) 598-0223
(405) 598-2833
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200199380A
—
OK
Enumeration date
04/14/2008
Last updated
03/25/2009
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