MEDICARE: PHOENIX HEALTHCARE 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
1	314000000X	Skilled Nursing Facility	NH7221	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104830421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHOENIX HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	1944 N IROQUOIS AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74106-4407
Country	:	US
Telephone Number	:	918-583-1509
Fax Number	:	918-583-1804

Provider Business Practice Location Address
First Line	:	1944 N IROQUOIS AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74106-4407
Country	:	US
Telephone Number	:	918-583-1509
Fax Number	:	918-583-1804

Authorized Official
Title or Position	:	MEDICARE SPECIALIST
Name	:	ANGELA MATTHEWS
Credential	:
Telephone Number	:	918-743-3638

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	08/08/2008

Similar Medicare Providers

1760871354 — MRS. JERRI DILLON RN
Practice Location Address:

2023 E 13TH PL
TULSA, OK
74104-4407

Practice Phone: 918-633-8859
Practice Fax:

1265920565 — ELITE SURGICAL ASSISTING, LLC
Practice Location Address:

2924 S 98TH EAST AVE
TULSA, OK
74129-4407

Practice Phone: 918-361-7366
Practice Fax:

1679418388 — TSES RESIDENTIAL LIVING
Practice Location Address:

2220 N NORFOLK AVE
TULSA, OK
74106-3917

Practice Phone: 918-629-2311
Practice Fax: 918-629-2311

1114923448 — MR. FRED GARFINKEL M.D.
Practice Location Address:

591 E 36TH ST N
TULSA, OK
74106-1812

Practice Phone: 918-619-8700
Practice Fax: 918-634-7884

1316948656 — MICHAEL T MONTAGUE PAC
Practice Location Address:

1334 N LANSING AVE
TULSA, OK
74106-5907

Practice Phone: 918-587-2171
Practice Fax: 918-295-6155

1164424990 — MALCOLM L. BUFORD JR. MD
Practice Location Address:

591 E 36TH ST N
TULSA, OK
74106-1812

Practice Phone: 918-619-4888
Practice Fax: 918-619-4591

Directions to “PHOENIX HEALTHCARE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.