| Advantage Home Medical | |
|
1514 Sw 119th St Oklahoma City OK 73170-4930 | |
| (405) 689-0433 | |
| Not Available |
| Full Name | Advantage Home Medical |
|---|---|
| Speciality | Clinic/Center |
| Location | 1514 Sw 119th St, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Michele Lynne Lange (APRN/OWNER) |
| Authorized Official Contact | 4056890433 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advantage Home Medical 904 Grandview Rd Tuttle OK 73089-8497 Ph: (405) 689-0433 | Advantage Home Medical 1514 Sw 119th St Oklahoma City OK 73170-4930 Ph: (405) 689-0433 |
| NPI Number | 1235902388 |
|---|---|
| Provider Enumeration Date | 10/31/2023 |
| Last Update Date | 10/31/2023 |
| Medicare PECOS PAC ID | 8921442286 |
|---|---|
| Medicare Enrollment ID | O20240215000486 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235902388 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Michele L Lange |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841424991 PECOS PAC ID: 3870631518 Enrollment ID: I20091117000481 |
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