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General NPI Number Information
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NPI Number | 1962761833
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Entity Type | Organization
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Legal Business Name | MILLENNIUM HOSPICE, INC.
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Dates
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Enumeration Date | 05/11/2012
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Last Update Date | 05/11/2012
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Provider Practice Location Address
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Address Line | 12129 E. SKELLY DR.
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City | TULSA
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State | OK
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Zip | 74128-2410
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Country | US
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Telephone | 918-493-6555
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Fax | 918-488-8825
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Provider Business Mailing Address
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Address Line | 12129 E. SKELLY DR.
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City | TULSA
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State | OK
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Zip | 74128-2410
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Country | US
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Telephone | 918-493-6555
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Fax | 918-488-8825
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID M. RANDALL
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Credential |
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Telephone | 918-493-6555
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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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