Healthcare Provider Details

I. General information

NPI: 1699974824
Provider Name (Legal Business Name): HEALTHCARE INNOVATIONS PRIVATE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 08/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 405-943-0094
  • Fax: 405-943-0193
Mailing address:
  • Phone: 405-943-0094
  • Fax: 405-943-0193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number7583
License Number StateOK

VIII. Authorized Official

Name: MRS. DEBRA K MILLER
Title or Position: VP
Credential:
Phone: 903-537-8656