Healthcare Provider Details

I. General information

NPI: 1740494566
Provider Name (Legal Business Name): HEALTHCARE INNOVATIONS PRIVATE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 E BROADWAY
LEXINGTON OK
73051
US

IV. Provider business mailing address

4300 HIGHLINE BLVD STE 380
OKLAHOMA CITY OK
73108-1851
US

V. Phone/Fax

Practice location:
  • Phone: 405-527-3494
  • Fax:
Mailing address:
  • Phone: 405-943-0094
  • 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: MS. LOLA J EDWARDS-JOHNSON
Title or Position: PRESIDENT
Credential: RN
Phone: 918-360-7014