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General NPI Number Information
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NPI Number | 1245391846
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Entity Type | Organization
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Legal Business Name | MEMORIAL HOSPITAL & PHYSICIAN GROUP HOME HEALTH
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 08/11/2008
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Provider Practice Location Address
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Address Line | 319 E JOSEPHINE AVE
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City | FREDERICK
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State | OK
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Zip | 73542-2220
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Country | US
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Telephone | 580-335-7565
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Fax | 580-335-7329
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Provider Business Mailing Address
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Address Line | 319 E. JOSEPHINE AVE
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City | FREDERICK
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State | OK
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Zip | 73542-2220
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Country | US
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Telephone | 580-335-6631
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Fax | 580-335-6607
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Authorized Official
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Title or Position | HOME HEALTH OFFICE MANAGER
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Name | MRS. NATALIE ANN HILBURN
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Credential |
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Telephone | 580-335-6631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 7128
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License Number State | OK
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