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NPI Code Detail

MEDICARE: PHC HEALTH, LLC

MEDICARE: PHC HEALTH, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency7724OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000377645-001OTHEROKBLUE CROSS & BLUE SHIED

General Provider Information

NPI Number : 1093826695
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHC HEALTH, LLC
Provider Business Mailing Address
First Line : 2831 NW 59TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-7005
Country : US
Telephone Number : 405-602-3295
Fax Number : 405-602-3297
Provider Business Practice Location Address
First Line : 2831 NW 59TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-7005
Country : US
Telephone Number : 405-602-3295
Fax Number : 405-602-3297
Authorized Official
Title or Position : CEO
Name : MR. BRIAN BANKS
Credential : CEO
Telephone Number : 405-602-3295
Provider Enumeration Date : 08/31/2006
Last Update Date : 06/18/2020

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Directions to “PHC HEALTH, LLC ” Practice Location

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