Organization
WHEATHEART NUTRITION PROJECT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN M WILLIS (PROJECT DIRECTOR)
(580) 262-0303
Entity
Organization
Contact information
Practice address
123 N MAIN ST, BLACKWELL, OK 74631-2226
(580) 262-0303
(580) 262-0301
Mailing address
123 N MAIN ST, PO BOX 606, BLACKWELL, OK 74631-2226
(580) 262-0303
(580) 262-0301
Taxonomy
Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100683190 A
SC PROVIDER NUMBER
OK
Enumeration date
11/19/2008
Last updated
08/09/2012
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