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Contact Information

HOME RUN HEALTHCARE
1425 EAST LINCOLN ROAD
SUITE A-3
IDABEL, OK74745
 Phone: 580-212-7237
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for HOME RUN HEALTHCARE · (Female)

NPI Number 1568957348
Status Active
Credentials
Entity Individual
Enumeration date 06/25/2018
Last updated 06/25/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • OK Medicaid 1679013676
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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