Provincial Home Care

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

4158 Issued in OK

Legal business name

PROVINCIAL HOME CARE

Doing business as

Community Hospice of Oklahoma

Practice address

3555 NW 58TH St
Ste. 900
Oklahoma City, OK 73112-4707

Phone

(405) 917-0650

Fax

(405) 917-0656

NPI assigned

Oct 31, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Steven L Edwards

Title

Executive Director

Phone

(405) 917-0650

Specialties & licenses 1

Addresses

Other names 1

• Community Hospice of Oklahoma Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285625186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 NW 58TH ST",
            "address_2": "STE. 900",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124707",
            "telephone_number": "405-917-0650",
            "fax_number": "405-917-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 NW 58TH ST",
            "address_2": "STE. 900",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124707",
            "telephone_number": "405-917-0650",
            "fax_number": "405-917-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVINCIAL HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "405-917-0650",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "OK",
            "license": "4158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Hospice of Oklahoma",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kiera R Proud, O.T.R.
• Nathan N. Proud, D.D.S.
• Tyler Jay Prouty
• Providence Family Practice, PLLC
• Providence Home Care LLC
• Provision Cares Proton Center Okc, LLC
• Provision Medical Supplies, Inc.
• Jessica Rae Provost, APRN
• Maria Gabriella Prudhomme, NP
• Geoffrey Allen Pruett, D.M.D.

• Community Based Hospice Care Agency in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Community Based Hospice Care Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.