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General NPI Number Information
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NPI Number | 1780505248
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Entity Type | Organization
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Legal Business Name | NORTH CANADIAN RIVER HEALTHCARE LLC
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Dates
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Enumeration Date | 07/22/2026
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Last Update Date | 07/22/2026
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Provider Practice Location Address
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Address Line | 3209 S BROADWAY STE 231 OFFICE 237
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City | EDMOND
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State | OK
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Zip | 73013-4063
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Country | US
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Telephone | 572-201-0020
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Fax |
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Provider Business Mailing Address
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Address Line | 3209 S BROADWAY STE 231
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City | EDMOND
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State | OK
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Zip | 73013-4063
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Country | US
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Telephone | 572-201-0020
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Fax |
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Authorized Official
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Title or Position | DIRECTOR- HOME CARE ADMINISTRATOR
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Name | SUSAN NICHOLS
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Credential |
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Telephone | 572-205-7881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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