MEDICARE: INTERIM HEALTHCARE OF OKLAHOMA CITY, INC.

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	7037	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720338932
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERIM HEALTHCARE OF OKLAHOMA CITY, INC.

Provider Business Mailing Address
First Line	:	5600 N MAY AVE
Second Line	:	SUITE 145
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-3973
Country	:	US
Telephone Number	:	405-848-3555
Fax Number	:	405-842-4629

Provider Business Practice Location Address
First Line	:	5600 N MAY AVE
Second Line	:	SUITE 145
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-3973
Country	:	US
Telephone Number	:	405-848-3555
Fax Number	:	405-842-4629

Authorized Official
Title or Position	:	CEO
Name	:	MR. JOSEPH S JOHNSON
Credential	:
Telephone Number	:	405-848-3555

Provider Enumeration Date	:	09/14/2012
Last Update Date	:	01/13/2013

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