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General NPI Number Information
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NPI Number | 1659458834
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Entity Type | Organization
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Legal Business Name | BRISTOW HEALTHCARE PROPERTIES LLC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 12/31/2008
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Provider Practice Location Address
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Address Line | 124 W 4TH AVE
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City | BRISTOW
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State | OK
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Zip | 74010-2823
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Country | US
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Telephone | 918-367-5644
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Fax | 918-367-2437
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Provider Business Mailing Address
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Address Line | 124 W 4TH AVE
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City | BRISTOW
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State | OK
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Zip | 74010-2823
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Country | US
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Telephone | 918-367-5644
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Fax | 918-367-2437
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. DEBBIE K CUPPS
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Credential | RN
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Telephone | 918-367-5644
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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 | 7143
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License Number State | OK
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