MEDICARE: CHOICE HOSPICE, 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	251G00000X	Community Based Hospice Care Agency	4202	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000371654001	OTHER	OK	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1811098163
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHOICE HOSPICE, INC

Provider Business Mailing Address
First Line	:	1232 SW 89TH ST STE C
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-9110
Country	:	US
Telephone Number	:	405-879-3470
Fax Number	:	405-879-1625

Provider Business Practice Location Address
First Line	:	1232 SW 89TH ST STE C
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-9110
Country	:	US
Telephone Number	:	405-879-3470
Fax Number	:	405-879-1625

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	LOLA JANE EDWARDS
Credential	:	RN
Telephone Number	:	405-879-3470

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	06/23/2023

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Directions to “CHOICE HOSPICE, INC ” Practice Location

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