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NPI Code Detail

MEDICARE: EXCELL PRIVATE CARE SERVICES

MEDICARE: EXCELL PRIVATE CARE SERVICES
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
1253Z00000XIn Home Supportive Care Agency7932OK

General Provider Information

NPI Number : 1154650018
Entity Type Code : Organization
Provider Name (Legal Business Name) : EXCELL PRIVATE CARE SERVICES
Provider Business Mailing Address
First Line : 1200 SW 104TH ST
Second Line : SUITE D
City : OKLAHOMA CITY
State : OK
Zip : 73139-3019
Country : US
Telephone Number : 405-631-0521
Fax Number : 405-639-2079
Provider Business Practice Location Address
First Line : 1200 SW 104TH ST
Second Line : SUITE D
City : OKLAHOMA CITY
State : OK
Zip : 73139-3019
Country : US
Telephone Number : 405-631-0521
Fax Number : 405-639-2079
Authorized Official
Title or Position : CEO/ADMINISTRATOR
Name : MINA ACQUAYE
Credential : RN, BSN, MPH, CHCE
Telephone Number : 405-631-0521
Provider Enumeration Date : 12/23/2009
Last Update Date : 12/23/2009

Similar Medicare Providers

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1831121672 — JULIE L BOWMAN LOWE M.D.
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Directions to “EXCELL PRIVATE CARE SERVICES ” Practice Location

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