Healthcare Provider Details

I. General information

NPI: 1689660706
Provider Name (Legal Business Name): ALTERNACARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 12/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3404 W OKMULGEE ST
MUSKOGEE OK
74401-5071
US

IV. Provider business mailing address

3404 W OKMULGEE ST
MUSKOGEE OK
74401-5071
US

V. Phone/Fax

Practice location:
  • Phone: 918-682-7773
  • Fax: 918-682-0496
Mailing address:
  • Phone: 918-682-7773
  • Fax: 918-682-0496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN WATSON
Title or Position: PRESIDENT
Credential: DPH
Phone: 918-682-7765