Provider Demographics
NPI:1154601417
Name:WEST, ALBERT
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:WEST
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 JORDAN DR
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-0833
Mailing Address - Country:US
Mailing Address - Phone:405-759-0661
Mailing Address - Fax:405-735-8585
Practice Address - Street 1:1404 JORDAN DR
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-0833
Practice Address - Country:US
Practice Address - Phone:405-759-0661
Practice Address - Fax:405-735-8585
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies