Organization
PONCA CITY HOME CARE SERVICES, LLC
Active
Other names
ASSURED HOME HEALTH OF PONCA CITY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA L. PROFFITT (PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
1924 LAKE RD, PONCA CITY, OK 74604-4800
(580) 765-8155
(580) 763-4549
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 443-4154
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000377089002
BCBS PROVIDER NUMBER
OK
05
—
200083820D
—
OK
Enumeration date
06/01/2006
Last updated
05/25/2023
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