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General NPI Number Information
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NPI Number | 1396792909
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Entity Type | Organization
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Legal Business Name | DURANT HMA HOME HEALTH, LLC
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 07/17/2014
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Provider Practice Location Address
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Address Line | 1400 BRYAN DR STE 211
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City | DURANT
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State | OK
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Zip | 74701-2156
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Country | US
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Telephone | 580-920-8040
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Fax | 580-920-8095
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Provider Business Mailing Address
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Address Line | 1400 BRYAN DR STE 211
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City | DURANT
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State | OK
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Zip | 74701-2156
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Country | US
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Telephone | 580-920-8040
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Fax | 580-920-8095
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | LAURIE J HOLTSFORD
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Credential |
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Telephone | 615-465-7466
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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 | 7117
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License Number State | OK
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