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NPI Code Detail

MEDICARE: HOME CARE MEDICAL, LLC

MEDICARE: HOME CARE MEDICAL, 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
13336C0003XCommunity/Retail Pharmacy1-4589OK
23336H0001XHome Infusion Therapy Pharmacy1-4589OK
3333600000XPharmacy1-4589OK

General Provider Information

NPI Number : 1740426915
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOME CARE MEDICAL, LLC
Provider Business Mailing Address
First Line : 220 NW 10TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73103-3902
Country : US
Telephone Number : 405-235-1468
Fax Number : 405-235-1476
Provider Business Practice Location Address
First Line : 220 NW 10TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73103-3902
Country : US
Telephone Number : 405-235-1468
Fax Number : 405-235-1476
Authorized Official
Title or Position : CEO/OWNER
Name : RAYMOND WILLINGHAM
Credential :
Telephone Number : 405-235-1468
Provider Enumeration Date : 12/18/2008
Last Update Date : 12/18/2008

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