Healthcare Provider Details

I. General information

NPI: 1235468596
Provider Name (Legal Business Name): AXIOM LINK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2009
Last Update Date: 12/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9620 S PENNSYLVANIA AVE UNIT C
OKLAHOMA CITY OK
73159-6904
US

IV. Provider business mailing address

9620 S PENNSYLVANIA AVE UNIT C
OKLAHOMA CITY OK
73159-6904
US

V. Phone/Fax

Practice location:
  • Phone: 405-735-6366
  • Fax: 405-735-6368
Mailing address:
  • Phone: 405-735-6366
  • Fax: 405-735-6368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JULIA SUE PADRON
Title or Position: CEO
Credential:
Phone: 212-684-0099