MEDICARE: TRADITIONS HOSPICE OF ELK CITY, 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	251G00000X	Community Based Hospice Care Agency

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	:	1902869738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRADITIONS HOSPICE OF ELK CITY, LLC

Provider Business Mailing Address
First Line	:	6840 CAROTHERS PKWY STE 550
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-8002
Country	:	US
Telephone Number	:	979-704-6547
Fax Number	:	866-908-8704

Provider Business Practice Location Address
First Line	:	212 SOUTH JEFFERSON AVENUE
Second Line	:
City	:	ELK CITY
State	:	OK
Zip	:	73644-5738
Country	:	US
Telephone Number	:	580-243-5000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	BRIAN LANTIER
Credential	:
Telephone Number	:	979-704-6574

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	11/17/2025

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