MEDICARE: SELF ENTERPRISES 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	253Z00000X	In Home Supportive Care Agency	HC7984	OK

General Provider Information

NPI Number	:	1255679148
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELF ENTERPRISES LLC

Provider Business Mailing Address
First Line	:	4430 NW 50TH ST
Second Line	:	SUITE N
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-2298
Country	:	US
Telephone Number	:	405-605-6064
Fax Number	:	405-605-6086

Provider Business Practice Location Address
First Line	:	4430 NW 50TH ST
Second Line	:	SUITE N
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-2298
Country	:	US
Telephone Number	:	405-605-6064
Fax Number	:	405-605-6086

Authorized Official
Title or Position	:	OWNER
Name	:	CRYSTAL SELF
Credential	:
Telephone Number	:	405-605-6064

Provider Enumeration Date	:	01/28/2013
Last Update Date	:	01/28/2013

Similar Medicare Providers

1497811996 — DR. STEVEN WAYNE DUFFY D.C.
Practice Location Address:

4430 NW 50TH ST , SUITE A
OKLAHOMA CITY, OK
73112-2298

Practice Phone: 405-949-0434
Practice Fax: 405-949-0330

1326366972 — WELCH PAIN RELIEF CENTER INC
Practice Location Address:

4430 NW 50TH , SUITE A
OKLAHOMA CITY, OK
73112-2298

Practice Phone: 405-949-0434
Practice Fax: 405-949-0330

1073119632 — KRISTEN RYDER SSP, LLMSW-C
Practice Location Address:

333 W GRANDVIEW PKWY STE 403
TRAVERSE CITY, MI
49684-2298

Practice Phone: 231-929-0300
Practice Fax:

1710963541 — ANNIE MCLENNAN CSAC II
Practice Location Address:

2298 NORRIS AVE
CRESCENT CITY, CA
95531-9344

Practice Phone: 707-464-2919
Practice Fax: 707-464-8218

1134191596 — MS. JOLENE SUE PRICE FNP
Practice Location Address:

7600 NW BELVIDERE PKWY
KANSAS CITY, MO
64152-2298

Practice Phone: 816-308-5297
Practice Fax: 816-741-1997

1427066505 — DR. MARVIN JEROME LEWIS D.C.
Practice Location Address:

3334 FM 1092 RD STE 450
MISSOURI CITY, TX
77459-2298

Practice Phone: 281-499-0123
Practice Fax: 281-499-0240

Directions to “SELF ENTERPRISES LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.