Healthcare Provider Details

I. General information

NPI: 1457785073
Provider Name (Legal Business Name): STEWART HEALTHCARE ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2013
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 E 15TH ST STE 500C
EDMOND OK
73013-6696
US

IV. Provider business mailing address

2411 SPRINGER DR
NORMAN OK
73069-3955
US

V. Phone/Fax

Practice location:
  • Phone: 405-735-6122
  • Fax: 405-735-6701
Mailing address:
  • Phone: 405-329-4545
  • Fax: 405-735-6701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number7819
License Number StateOK

VIII. Authorized Official

Name: MRS. KAREN VAHLBERG
Title or Position: PRESIDENT
Credential:
Phone: 405-735-6122