Organization
VICTORY HOSPICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM CRIPPS RN (ADMINISTRATOR)
(580) 371-2002
Entity
Organization
Contact information
Practice address
750 E MAIN ST, TISHOMINGO, OK 73460-2350
(580) 371-2002
(580) 371-2058
Mailing address
714 E MAIN ST, TISHOMINGO, OK 73460-2350
(580) 371-2002
(580) 371-2058
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
4099
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200010380A
—
OK
Enumeration date
01/04/2006
Last updated
06/17/2015
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