Healthcare Provider Details

I. General information

NPI: 1952667651
Provider Name (Legal Business Name): HEALTHCARE INNOVATIONS IN-HOME SERVICES OF PURCELL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2012
Last Update Date: 05/20/2020
Certification Date: 05/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 N MAIN
PURCELL OK
73080-4222
US

IV. Provider business mailing address

210 N MAIN
PURCELL OK
73080-4222
US

V. Phone/Fax

Practice location:
  • Phone: 405-527-0480
  • Fax:
Mailing address:
  • Phone: 405-527-0480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. LOLA JANE EDWARDS
Title or Position: PRESIDENT /ADMINISTRATOR
Credential: RN
Phone: 918-360-7014