Organization
SUPRA HOME CARE, INC.
Active
Other names
SUPRA Home Care of Tulsa
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY BUTLER (PRESIDENT/CEO)
(504) 837-5557
Entity
Organization
Contact information
Practice address
11333 E PINE ST, SUITE 10A, TULSA, OK 74116-2023
(918) 493-1100
(918) 437-3529
Mailing address
PO BOX 6588, METAIRIE, LA 70009-6588
(504) 837-5557
(504) 833-3466
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
7147
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100260570A
—
OK
Enumeration date
07/06/2006
Last updated
06/08/2011
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