MEDICARE: EPIC HEART HEALTH

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	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1730790148
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EPIC HEART HEALTH

Provider Business Mailing Address
First Line	:	1211 N SHARTEL AVE STE 1005
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73103-2433
Country	:	US
Telephone Number	:	405-604-6700
Fax Number	:	405-604-6728

Provider Business Practice Location Address
First Line	:	1211 N SHARTEL AVE STE 1005
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73103-2433
Country	:	US
Telephone Number	:	405-604-6700
Fax Number	:	405-604-6728

Authorized Official
Title or Position	:	OWNER
Name	:	SENTHIL NACHIMUTHU
Credential	:	MD
Telephone Number	:	405-604-6700

Provider Enumeration Date	:	08/11/2020
Last Update Date	:	08/11/2020

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Directions to “EPIC HEART HEALTH ” Practice Location

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