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General NPI Number Information
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NPI Number | 1326047762
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Entity Type | Organization
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Legal Business Name | RED RIVER HOSPICE
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3525 NW 23RD ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73107-2801
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Country | US
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Telephone | 405-943-8277
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Fax | 405-947-0158
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Provider Business Mailing Address
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Address Line | 3525 NW 23RD ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73107-2801
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Country | US
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Telephone | 405-943-8277
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Fax | 405-947-0158
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Authorized Official
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Title or Position | DIRECTOR OF BUSINESS OPERATIONS
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Name | MS. NANCY LYNN ST. LAURENT
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Credential | NCICS, NCMAA
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Telephone | 405-943-8277
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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 | 4128
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License Number State | OK
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