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General NPI Number Information
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NPI Number | 1922040385
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Entity Type | Organization
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Legal Business Name | WALDRICH, INC.
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 122 N BRYANT AVE
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City | EDMOND
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State | OK
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Zip | 73034-6303
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Country | US
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Telephone | 405-341-4883
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Fax | 405-844-3297
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Provider Business Mailing Address
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Address Line | 13204 N MACARTHUR BLVD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73142-3019
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Country | US
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Telephone | 405-721-8802
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Fax | 405-721-8166
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Authorized Official
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Title or Position | BILLING OFFICE MANAGER
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Name | MISS CATHERINE MARIE KINNEY
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Credential |
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Telephone | 405-721-8802
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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 | 4117
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License Number State | OK
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