Provider Demographics
NPI:1316494818
Name:DISCOVER DME LLC
Entity type:Organization
Organization Name:DISCOVER DME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:YORK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-733-3955
Mailing Address - Street 1:1401 S DOUGLAS BLVD STE W.2
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-5200
Mailing Address - Country:US
Mailing Address - Phone:405-733-3955
Mailing Address - Fax:405-733-4014
Practice Address - Street 1:1401 S DOUGLAS BLVD STE W.2
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-5200
Practice Address - Country:US
Practice Address - Phone:405-733-3955
Practice Address - Fax:405-733-4014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies