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General NPI Number Information
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NPI Number | 1740247865
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Entity Type | Organization
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Legal Business Name | CARTER HEALTHCARE OF BRADY, LLC
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 12/28/2023
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Provider Practice Location Address
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Address Line | 2203 S BRIDGE ST STE 100
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City | BRADY
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State | TX
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Zip | 76825-7443
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Country | US
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Telephone | 325-597-3107
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Fax | 325-597-3109
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Provider Business Mailing Address
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Address Line | 3105 S MERIDIAN AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73119-1022
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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 | 008954
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License Number State | TX
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