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General NPI Number Information
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NPI Number | 1346359411
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Entity Type | Organization
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Legal Business Name | CARTER HEALTHCARE OF SOUTH OKLAHOMA, LLC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 1052 NORTHWEST BLVD
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City | ARDMORE
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State | OK
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Zip | 73401-1533
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Country | US
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Telephone | 580-226-3166
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Fax | 580-226-5901
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 7777
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License Number State | OK
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