Provider Demographics
NPI:1225275258
Name:HILLTOP HEALTHCARE, LLC
Entity Type:Organization
Organization Name:HILLTOP HEALTHCARE, LLC
Other - Org Name:VALLEY VIEW HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:EZELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-687-8033
Mailing Address - Street 1:3310 CHANDLER RD
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403-4906
Mailing Address - Country:US
Mailing Address - Phone:918-687-8033
Mailing Address - Fax:918-687-4092
Practice Address - Street 1:401 N MONTE VISTA ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-4609
Practice Address - Country:US
Practice Address - Phone:580-332-1892
Practice Address - Fax:580-332-3519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7201251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK377011Medicare Oscar/Certification