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General NPI Number Information
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NPI Number | 1801958244
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Entity Type | Organization
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Legal Business Name | DAVID'S HEALTH CENTER, INC.
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 01/03/2012
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Provider Practice Location Address
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Address Line | 200 N. MAIN ST.
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City | FORT TOWSON
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State | OK
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Zip | 74735-0116
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Country | US
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Telephone | 580-873-2876
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Fax | 580-873-2841
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Provider Business Mailing Address
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Address Line | 200 N. MAIN ST. P.O. BOX 116
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City | FORT TOWSON
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State | OK
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Zip | 74735-0116
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Country | US
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Telephone | 580-873-2876
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Fax | 580-873-2841
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Authorized Official
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Title or Position | C.F.O.
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Name | MR. JERRY WAYNE DAVID
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Credential |
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Telephone | 580-873-2876
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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 | 7384
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License Number State | OK
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