Organization Name: | HOSPICE OF NORTHEAST OKLHOMA LLC |
NPI Number: | 1508140096 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK C ROWE (CEO/PRESIDENT) |
Mailing Address: | 12657 S State Highway 51 Coweta |
State: | OK US |
Postal Code: | 744296476 |
Phone Number: | 9186229281 |
Fax Number: | 9182702867 |
NPI Enumeration Date: | 10/04/2011 |
NPI Last Update Date: | 10/04/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 4147 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |