Provider Demographics
NPI:1962024992
Name:A&B ENGRAVING, INC DBA A&B IDENTITY
Entity type:Organization
Organization Name:A&B ENGRAVING, INC DBA A&B IDENTITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-663-7446
Mailing Address - Street 1:2020 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-1816
Mailing Address - Country:US
Mailing Address - Phone:918-663-7446
Mailing Address - Fax:
Practice Address - Street 1:2020 E 3RD ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-1816
Practice Address - Country:US
Practice Address - Phone:918-663-7446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
3FY7NLV00OtherHIN - HEALTH INDUSTRY NUMBER