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HOME RUN HEALTHCARE NPI 1568957348


NPI Information

NPI: 1568957348
Provider Name: HOME RUN HEALTHCARE
Classification: Family Medicine - 207QG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

CLIA Number: 37D2151070

Address:
1425 EAST LINCOLN ROAD
SUITE A-3
IDABEL, OK
ZIP 74745
Phone: (580) 212-7237
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HOME RUN HEALTHCARE is a geriatric medicine family medicine in Idabel, OK. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. HOME RUN HEALTHCARE NPI is 1568957348. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1425 EAST LINCOLN ROAD
SUITE A-3
IDABEL, OK
ZIP 74745
Phone: (580) 212-7237

The provider's authorized official is Ashlei Jobe .
The authorized official title is President and has the following contact phone number (580) 212-7237.

The CLIA number assigned to this NPI record is 37D2151070 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/25/2018 and was last updated on 6/25/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QG0300XFamily MedicineGeriatric MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11679013676MEDICAIDOKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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