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General NPI Number Information
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NPI Number | 1740426915
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Entity Type | Organization
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Legal Business Name | HOME CARE MEDICAL, LLC
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Dates
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Enumeration Date | 12/18/2008
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Last Update Date | 12/18/2008
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Provider Practice Location Address
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Address Line | 220 NW 10TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73103-3902
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Country | US
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Telephone | 405-235-1468
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Fax | 405-235-1476
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Provider Business Mailing Address
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Address Line | 220 NW 10TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73103-3902
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Country | US
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Telephone | 405-235-1468
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Fax | 405-235-1476
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Authorized Official
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Title or Position | CEO/OWNER
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Name | RAYMOND WILLINGHAM
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Credential |
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Telephone | 405-235-1468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 1-4589
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | 1-4589
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 1-4589
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License Number State | OK
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