Provider Demographics
NPI:1215289889
Name:OKLAHOMA MOBILITY SOLUTIONS LLC
Entity type:Organization
Organization Name:OKLAHOMA MOBILITY SOLUTIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:RANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-455-3716
Mailing Address - Street 1:2712 MILTON AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-1521
Mailing Address - Country:US
Mailing Address - Phone:214-455-3716
Mailing Address - Fax:
Practice Address - Street 1:9402 E 55TH PL
Practice Address - Street 2:SUITE A
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-8173
Practice Address - Country:US
Practice Address - Phone:214-455-3716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JGLM CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies