Healthcare Provider Details

I. General information

NPI: 1518172956
Provider Name (Legal Business Name): HCAP VENTURE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 NW 7TH ST
OKLAHOMA CITY OK
73102-1212
US

IV. Provider business mailing address

700 NW 7TH ST
OKLAHOMA CITY OK
73102-1212
US

V. Phone/Fax

Practice location:
  • Phone: 405-553-1194
  • Fax: 405-239-7180
Mailing address:
  • Phone: 405-553-1194
  • Fax: 405-239-7180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number2296
License Number StateOK

VIII. Authorized Official

Name: MRS. STACY B SMITH
Title or Position: CEO
Credential:
Phone: 405-553-1194