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General NPI Number Information
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NPI Number | 1972520435
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Entity Type | Organization
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Legal Business Name | SHEPHERD HOME HEALTH & HOSPICE, LLC.
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 812 W GARY BLVD
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City | CLINTON
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State | OK
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Zip | 73601-2720
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Country | US
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Telephone | 580-323-1580
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Fax | 580-323-2581
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Provider Business Mailing Address
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Address Line | 812 W GARY BLVD
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City | CLINTON
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State | OK
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Zip | 73601-2720
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Country | US
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Telephone | 580-323-1580
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Fax | 580-323-2581
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Authorized Official
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Title or Position | CEO
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Name | MR. JAMES ALLEN SHEPHERD
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Credential |
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Telephone | 580-323-1580
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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 | PENDING
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License Number State | OK
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