<Unavail>
LBN: Boomer 06, Pllc
<Unavail> is an health care organization with primary practice located at 10921 S Western Ave Ste 200 , Oklahoma City OK 73170-6228. The organization recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Suppliers / Durable Medical Equipment & Medical Supplies. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is the primary health care specialty.
Boomer 06, Pllc can be contacted via phone (405) 996-0660, or through Elassal, Ryan Edward via phone (405) 996-0660.
Contact Information
Primary practice address
10921 S Western Ave Ste 200
Oklahoma City OK 73170-6228
Phone: (405) 996-0660
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | ||
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X |
Profile Details
| NPI number | 1871126383 |
|---|---|
| LBN Legal business name | Boomer 06, Pllc |
| DBA Doing business as | <Unavail> |
| Authorized official | Elassal, Ryan Edward |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 13th, 2020 |
| Last updated | Oct 22nd, 2024 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871126383 | NPPES |
| Oklahoma | MEDICAID | 200934220A |
Popular Providers
-
Speech Heart Services
11900 N Macarthur Blvd Ste B , Oklahoma City OK 73162-1860 -
Move Pllc
9433 N Kelley Ave , Oklahoma City OK 73131-2415 -
Specialized Physical Therapy Pc
3333 W Hefner Road Suite A, Oklahoma City OK 73120 -
Mcbride Clinic Inc
1110 N Lee Ave , Oklahoma City OK 73103-2612 -
Optimal Rehab Llc
430 Nw 10Th St , Oklahoma City OK 73103-3910 -
Advanced Science And Technology Education Charter Schools
2401 Nw 23Rd St Suite 3, Oklahoma City OK 73107-2442 -
Elite Pain & Health Pc
13100 N Western Ave Ste 303 , Oklahoma City OK 73114-1432 -
Ptms 3.0, Llc
10740 S May Ave , Oklahoma City OK 73170-2454