Organization
PROFESSIONAL HOME HEALTH CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELISAQ KAYE SANDERS R.N. (PRESIDENT/OWNER)
(918) 270-4950
Entity
Organization
Contact information
Practice address
109 N BLAKE, WAGONER, OK 74467
(918) 485-8565
(918) 485-8779
Mailing address
10301 E 51 ST., SUITE C, TULSA, OK 74146-5808
(918) 270-4950
(918) 270-4952
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100808980A
—
OK
Enumeration date
04/28/2006
Last updated
09/18/2009
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