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NPI 1427152685

NPI 1427152685 : CARTER HEALTHCARE OF NORTHEAST OKLAHOMA, LLC : BIXBY, OK

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General NPI Number Information
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    NPI Number           |    1427152685
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    Entity Type          |    Organization 
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    Legal Business Name  |    CARTER HEALTHCARE OF NORTHEAST OKLAHOMA, LLC 
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Dates
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    Enumeration Date     |    09/11/2006
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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 EAST 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 OFFIC/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       |    7688
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    License Number State |    OK
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