Healthcare Provider Details

I. General information

NPI: 1417974296
Provider Name (Legal Business Name): MARSHALL COUNTY HOME HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 10/22/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W LILLIE BLVD
MADILL OK
73446-1253
US

IV. Provider business mailing address

PO BOX 278
MADILL OK
73446-0278
US

V. Phone/Fax

Practice location:
  • Phone: 580-795-9992
  • Fax: 580-795-7609
Mailing address:
  • Phone: 580-795-9992
  • Fax: 580-795-7609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number7016
License Number StateOK

VIII. Authorized Official

Name: MS. KIMBERLY ANN SIMMONS
Title or Position: CEO
Credential:
Phone: 580-795-9992