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Organization

HOLDENVILLE HOME HEALTH, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MARSHA L. MATHIS (OFFICE MANAGER)
(405) 379-2300
Entity
Organization

Contact information

Practice address
711 N BULLITT ST, SUITE B, HOLDENVILLE, OK 74848-3804
(405) 379-2300
(405) 379-2309
Mailing address
711 N BULLITT ST, SUITE B, HOLDENVILLE, OK 74848-3804
(405) 379-2300
(405) 379-2309

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
377448
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000377448001
BC/BS #
OK
05
100699880D
OK
Enumeration date
06/11/2006
Last updated
03/23/2009
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