MEDICARE: MUJANGS CARE 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	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HC8145	OTHER	OK	STATE LICENSE NUMBER

General Provider Information

NPI Number	:	1245977438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MUJANGS CARE LLC

Provider Business Mailing Address
First Line	:	6101 MELROSE LN
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73127-5529
Country	:	US
Telephone Number	:	405-264-2214
Fax Number	:

Provider Business Practice Location Address
First Line	:	6101 MELROSE LN
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73127-5529
Country	:	US
Telephone Number	:	405-264-2214
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF BUSINESS DEVELOPMENT
Name	:	GREG LORSON
Credential	:
Telephone Number	:	850-252-2696

Provider Enumeration Date	:	05/18/2022
Last Update Date	:	05/18/2022

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Directions to “MUJANGS CARE LLC ” Practice Location

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