Healthcare Provider Details

I. General information

NPI: 1073582045
Provider Name (Legal Business Name): S-Q HOME CARE SPECIALTIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 02/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 N HEMLOCK CIR
BROKEN ARROW OK
74012-1171
US

IV. Provider business mailing address

2400 N HEMLOCK CIR
BROKEN ARROW OK
74012-1171
US

V. Phone/Fax

Practice location:
  • Phone: 918-251-0070
  • Fax: 918-258-9229
Mailing address:
  • Phone: 918-251-0070
  • Fax: 918-258-9229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number7670
License Number StateOK

VIII. Authorized Official

Name: MRS. MAGDALENE E QUAYE
Title or Position: ADMINISTRATOR
Credential: RN.C
Phone: 918-251-0070