MEDICARE: CARTER HEALTHCARE HOSPICE OF CENTRAL OKLAHOMA, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency	4029	OK

General Provider Information

NPI Number	:	1134236573
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARTER HEALTHCARE HOSPICE OF CENTRAL OKLAHOMA, LLC

Provider Business Mailing Address
First Line	:	7725 W RENO AVE STE 332
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73127-9799
Country	:	US
Telephone Number	:	405-688-2120
Fax Number	:	405-947-7300

Provider Business Practice Location Address
First Line	:	7725 W RENO AVE STE 303
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73127-9795
Country	:	US
Telephone Number	:	405-947-7700
Fax Number	:	405-947-7300

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL/PRESIDENT
Name	:	JUSTIN CARTER
Credential	:
Telephone Number	:	405-947-7700

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	03/09/2026

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