Healthcare Provider Details

I. General information

NPI: 1184784563
Provider Name (Legal Business Name): OLDER CITIZENS SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E ANGUS AVE
DEWEY OK
74029-2706
US

IV. Provider business mailing address

300 E ANGUS AVE
DEWEY OK
74029-2706
US

V. Phone/Fax

Practice location:
  • Phone: 918-534-1270
  • Fax: 918-534-1606
Mailing address:
  • Phone: 918-534-1270
  • Fax: 918-534-1606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: MRS. PAULETTE WHEAT
Title or Position: ASSISTANT DIRECTOR
Credential:
Phone: 918-534-1270