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General NPI Number Information
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NPI Number | 1295842664
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Entity Type | Organization
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Legal Business Name | CARTER HEALTHCARE HOSPICE OF NORTHEAST OKLAHOMA, LLC
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 6630 E 121ST ST SUITE 108
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City | BIXBY
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State | OK
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Zip | 74008
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Country | US
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Telephone | 918-425-4000
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Fax | 918-428-0780
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Provider Business Mailing Address
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Address Line | 7725 W RENO AVE STE 332
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City | OKLAHOMA CITY
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State | OK
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Zip | 73127-9799
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Country | US
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Telephone | 405-947-7700
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Fax | 405-947-7300
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL/PRESIDENT
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Name | JUSTIN CARTER
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Credential |
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Telephone | 405-947-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 4042
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License Number State | OK
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