Imed Supply

LBN: Innovative Medical Supply, Llc
Imed Supply is an health care organization with primary practice located at 1501 Se 4Th St Suite D, Moore OK 73160-8231. The organization recently has only one registered license in Suppliers / Durable Medical Equipment & Medical Supplies, which is considered as the primary health care specialty. Innovative Medical Supply, Llc can be contacted via phone (405) 799-8855, or through Berry, Brian K via phone (405) 799-8855.

Contact Information

Primary practice address
1501 Se 4Th St Suite D Moore OK 73160-8231
Phone: (405) 799-8855
Fax: (405) 799-8860
Website:
Map and Directions
Authorized official contact:
Name: Berry, Brian K
Phone: (405) 799-8855

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X

Profile Details

NPI number 1679570121
LBN Legal business name Innovative Medical Supply, Llc
DBA Doing business as Imed Supply
Authorized official Berry, Brian K
Entity Organization
Organization subpart 1 No
Enumeration date Jun 30th, 2005
Last updated Aug 30th, 2022 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679570121 NPPES
Oklahoma MEDICAID 2023000A
Oklahoma Other 209078400
Oklahoma Other 20536475001

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