Healthcare Provider Details

I. General information

NPI: 1003747957
Provider Name (Legal Business Name): HOMETOWN HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5575 N COUNCIL AVE
BLANCHARD OK
73010-8049
US

IV. Provider business mailing address

5575 N COUNCIL AVE
BLANCHARD OK
73010-8049
US

V. Phone/Fax

Practice location:
  • Phone: 405-597-2194
  • Fax:
Mailing address:
  • Phone: 405-597-2194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMBER GARRETT
Title or Position: NURSE PRACTITIONER/OWNER
Credential:
Phone: 405-597-2194