MEDICARE: CWM HOSPICE CARE 2, 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	251G00000X	Community Based Hospice Care Agency	4192	OK

General Provider Information

NPI Number	:	1760599070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CWM HOSPICE CARE 2, LLC

Provider Business Mailing Address
First Line	:	540 E APPLEBY RD STE 104
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72703-4114
Country	:	US
Telephone Number	:	405-594-9990
Fax Number	:	405-594-9994

Provider Business Practice Location Address
First Line	:	201 NW 63RD ST STE 230
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-8232
Country	:	US
Telephone Number	:	55-949-9904
Fax Number	:	95-949-9944

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL/PRESIDENT
Name	:	WILLIAM MCARDLE
Credential	:
Telephone Number	:	405-594-9990

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	02/23/2024

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