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General NPI Number Information
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NPI Number | 1740612761
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Entity Type | Organization
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Legal Business Name | FAMILY CHOICE HOSPICE LLC
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Dates
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Enumeration Date | 08/01/2013
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Last Update Date | 06/23/2023
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Provider Practice Location Address
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Address Line | 3109 AZALEA PARK DR
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City | MUSKOGEE
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State | OK
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Zip | 74401-2284
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Country | US
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Telephone | 918-933-5093
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Fax | 918-681-4995
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Provider Business Mailing Address
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Address Line | 3109 AZALEA PARK DR
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City | MUSKOGEE
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State | OK
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Zip | 74401-2284
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Country | US
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Telephone | 918-933-5093
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Fax | 918-681-4995
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LOLA JANE EDWARDS
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Credential | RN
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Telephone | 918-681-4988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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