Healthcare Provider Details

I. General information

NPI: 1255434189
Provider Name (Legal Business Name): JUDITH KARMAN HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 S MAIN ST
STILLWATER OK
74074-4635
US

IV. Provider business mailing address

915 S MAIN ST
STILLWATER OK
74074
US

V. Phone/Fax

Practice location:
  • Phone: 405-377-8012
  • Fax:
Mailing address:
  • Phone: 405-377-8012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number4016
License Number StateOK

VIII. Authorized Official

Name: MARY LEE WARREN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 405-377-8012