Provider Demographics
NPI:1427249762
Name:CIMARRON RENTAL, INC.
Entity type:Organization
Organization Name:CIMARRON RENTAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOKKEEPER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-330-7908
Mailing Address - Street 1:4412 N AIR DEPOT
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-9518
Mailing Address - Country:US
Mailing Address - Phone:405-330-7908
Mailing Address - Fax:405-216-0041
Practice Address - Street 1:3620 S KELLY AVE
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3805
Practice Address - Country:US
Practice Address - Phone:405-330-7908
Practice Address - Fax:405-216-0041
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BURNETT MEDICAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-01
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK0583280001Medicare NSC