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General NPI Number Information
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NPI Number | 1487718011
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Entity Type | Organization
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Legal Business Name | GREEN COUNTRY HOME HEALTH CARE INC
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 2738 E 51ST ST STE 240
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City | TULSA
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State | OK
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Zip | 74105-6271
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Country | US
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Telephone | 918-783-5720
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Fax | 918-783-5760
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Provider Business Mailing Address
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Address Line | 2738 E 51ST ST STE 240
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City | TULSA
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State | OK
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Zip | 74105-6271
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Country | US
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Telephone | 918-783-5720
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Fax | 918-783-5760
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Authorized Official
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Title or Position | CFO
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Name | MR. STEVEN CLARK GRAY
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Credential | MBA
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Telephone | 918-783-5720
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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 | 7610
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License Number State | OK
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