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Organization

COUNTRY STYLE HEALTH CARE INC IV

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JACKIE C BROWNE (VP OF OPERATIONS)
(918) 689-5352
Entity
Organization

Contact information

Practice address
301 S MAIN ST, EUFAULA, OK 74432-3253
(918) 689-5352
(918) 689-9446
Mailing address
301 S MAIN ST, EUFAULA, OK 74432-3253
(918) 689-5352
(918) 689-9446

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC7647
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100261740B
OK
05
100261740C
OK
05
100261740F
OK
05
100261740G
OK
05
100261740H
OK
05
100261740I
OK
05
100261740J
OK
05
100261740K
OK
05
100261740L
OK
Enumeration date
08/26/2005
Last updated
08/17/2018
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