Provider Demographics
NPI:1164580395
Name:A-VOW HOSPICE, INC.
Entity Type:Organization
Organization Name:A-VOW HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAGDALENE
Authorized Official - Middle Name:
Authorized Official - Last Name:QUAYE
Authorized Official - Suffix:
Authorized Official - Credentials:RN BC
Authorized Official - Phone:918-259-0049
Mailing Address - Street 1:2400 N HEMLOCK CIR
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-1171
Mailing Address - Country:US
Mailing Address - Phone:918-259-0049
Mailing Address - Fax:
Practice Address - Street 1:2400 N HEMLOCK CIR
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-1171
Practice Address - Country:US
Practice Address - Phone:918-259-0049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK371689Medicare Oscar/Certification