MEDICARE: SUPRA HOME CARE, INC.

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	251E00000X	Home Health Agency	7147	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	:	1306878947
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPRA HOME CARE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 6588
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70009-6588
Country	:	US
Telephone Number	:	504-837-5557
Fax Number	:	504-833-3466

Provider Business Practice Location Address
First Line	:	11333 E PINE ST
Second Line	:	SUITE 10A
City	:	TULSA
State	:	OK
Zip	:	74116-2023
Country	:	US
Telephone Number	:	918-493-1100
Fax Number	:	918-437-3529

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	LARRY BUTLER
Credential	:
Telephone Number	:	504-837-5557

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	06/08/2011

Similar Medicare Providers

1285050831 — MS. REGINA KAY TISDALE
Practice Location Address:

3600 W APACHE ST
TULSA, OK
74127-2023

Practice Phone: 918-284-4837
Practice Fax:

1760871354 — MRS. JERRI DILLON RN
Practice Location Address:

2023 E 13TH PL
TULSA, OK
74104-4407

Practice Phone: 918-633-8859
Practice Fax:

1235679259 — TANEESHA HOOKS
Practice Location Address:

6126 E 32ND PL , APT 2023
TULSA, OK
74135-5406

Practice Phone: 918-557-8482
Practice Fax:

1437253176 — DAVID K MILLER MD
Practice Location Address:

15905 E OKLAHOMA ST
TULSA, OK
74116-2408

Practice Phone: 580-223-9355
Practice Fax:

1346315546 — STEVEN A LAUDENBACK DC
Practice Location Address:

913 N 161ST EAST AVE , STE E
TULSA, OK
74116

Practice Phone: 918-672-2773
Practice Fax: 918-439-0222

1598831448 — LARRY D LAUDENBACK DC
Practice Location Address:

913 N 161ST E AVE , SUITE E
TULSA, OK
74116

Practice Phone: 918-672-2734
Practice Fax: 918-439-0222

Directions to “SUPRA HOME CARE, INC. ” 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.