Provider Demographics
NPI:1871778548
Name:VINITA MEDICAL EQUIPMENT, LLC
Entity type:Organization
Organization Name:VINITA MEDICAL EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAWNNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-323-0441
Mailing Address - Street 1:PO BOX 1182
Mailing Address - Street 2:
Mailing Address - City:VINITA
Mailing Address - State:OK
Mailing Address - Zip Code:74301-1182
Mailing Address - Country:US
Mailing Address - Phone:918-323-0441
Mailing Address - Fax:918-323-0442
Practice Address - Street 1:405 N WILSON ST
Practice Address - Street 2:
Practice Address - City:VINITA
Practice Address - State:OK
Practice Address - Zip Code:74301-2432
Practice Address - Country:US
Practice Address - Phone:918-323-0441
Practice Address - Fax:918-323-0442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies