MEDICARE: JANE PHILLIPS REGIONAL HOME CARE, 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	251E00000X	Home Health Agency	7217	OK

General Provider Information

NPI Number	:	1750425104
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JANE PHILLIPS REGIONAL HOME CARE, LLC.

Provider Business Mailing Address
First Line	:	10 CADILLAC DR STE 400
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-1001
Country	:	US
Telephone Number	:	615-637-9163
Fax Number	:	615-373-4457

Provider Business Practice Location Address
First Line	:	3061 SE WASHINGTON BLVD
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-7629
Country	:	US
Telephone Number	:	918-907-3010
Fax Number	:	844-721-8184

Authorized Official
Title or Position	:	SVP CHIEF LEGAL OFFICER
Name	:	RUSSELL ADKINS
Credential	:
Telephone Number	:	615-309-5668

Provider Enumeration Date	:	02/19/2007
Last Update Date	:	06/22/2022

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