Healthcare Provider Details

I. General information

NPI: 1952789554
Provider Name (Legal Business Name): HEALTH WATCH HEALTH CARE OF GUYMON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2015
Last Update Date: 05/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 N ELLISON ST
GUYMON OK
73942
US

IV. Provider business mailing address

3310 LAMAR AVE SUITE A
PARIS TX
75460
US

V. Phone/Fax

Practice location:
  • Phone: 580-338-2274
  • Fax:
Mailing address:
  • Phone: 903-905-4810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ERIK DRENNEN
Title or Position: CEO
Credential:
Phone: 903-905-4810