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Organization

COMPLETE HOME HEALTH OF TISHOMINGO LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LOLA JANE EDWARDS RN BSN MS (PRESIDENT)
(803) 719-3005
Entity
Organization

Contact information

Practice address
315 N WESTERN AVE, TISHOMINGO, OK 73460-4824
(580) 371-9300
Mailing address
315 N WESTERN AVE, TISHOMINGO, OK 73460-4824
(580) 371-9300

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
7830
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7830
LICENSE
OK
Enumeration date
01/03/2014
Last updated
06/23/2023
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