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General NPI Number Information
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NPI Number | 1770655888
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Entity Type | Organization
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Legal Business Name | AMERICAN HOSPICE, LLC
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 01/11/2016
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Provider Practice Location Address
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Address Line | 6950 S UTICA AVE
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City | TULSA
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State | OK
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Zip | 74136-3903
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Country | US
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Telephone | 918-742-6415
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Fax | 918-742-6413
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Provider Business Mailing Address
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Address Line | 6950 S UTICA AVE
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City | TULSA
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State | OK
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Zip | 74136-3903
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Country | US
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Telephone | 918-742-6415
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Fax | 918-742-6413
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. SHERRY JEAN CROCKETT
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Credential | LPN, BA
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Telephone | 918-742-6415
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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 | 4163
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License Number State | OK
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Taxonomy #2
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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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