Provider Demographics
NPI:1841497823
Name:THERAID MANUFACTURING, INC.
Entity type:Organization
Organization Name:THERAID MANUFACTURING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ROGER
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:405-732-8900
Mailing Address - Street 1:2904 PARKLAWN DR
Mailing Address - Street 2:PO BOX 30236
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-4204
Mailing Address - Country:US
Mailing Address - Phone:405-732-8900
Mailing Address - Fax:405-732-8974
Practice Address - Street 1:2904 PARKLAWN DR
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-4204
Practice Address - Country:US
Practice Address - Phone:405-732-8900
Practice Address - Fax:405-732-8974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK072351332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment