MEDICARE: SNOW HEALTH CARE

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	251B00000X	Case Management Agency	1539	OK

General Provider Information

NPI Number	:	1437309515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SNOW HEALTH CARE

Provider Business Mailing Address
First Line	:	4800 N MAYFAIR DR
Second Line	:	SUITE A
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-8209
Country	:	US
Telephone Number	:	405-702-1553
Fax Number	:

Provider Business Practice Location Address
First Line	:	4800 N MAYFAIR DR
Second Line	:	SUITE A
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-8209
Country	:	US
Telephone Number	:	405-702-1553
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ROBERTA LYNN SNOW
Credential	:	ACSW, LSW, CCM
Telephone Number	:	405-702-1553

Provider Enumeration Date	:	09/24/2008
Last Update Date	:	09/24/2008

Similar Medicare Providers

1215189980 — ROBERTA LYNN SNOW LCSW, CCM
Practice Location Address:

4800 N MAYFAIR DR
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1154742948 — OCCUPATIONAL HEALTH CENTERS OF THE SOUTHWEST PA
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1023003936 — JONATHAN P MOORMAN M.D.
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Directions to “SNOW HEALTH CARE ” Practice Location

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