Organization
PHC HEALTH, LLC
Active
Other names
Providence Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN BANKS CEO (CEO)
(405) 602-3295
Entity
Organization
Contact information
Practice address
2831 NW 59TH ST, OKLAHOMA CITY, OK 73112-7005
(405) 602-3295
(405) 602-3297
Mailing address
2831 NW 59TH ST, OKLAHOMA CITY, OK 73112-7005
(405) 602-3295
(405) 602-3297
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
7724
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000377645-001
BLUE CROSS & BLUE SHIED
OK
05
—
100262820A
—
OK
Enumeration date
08/31/2006
Last updated
06/18/2020
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