Provider Demographics
NPI:1407533854
Name:OLDHAM HOSPICE SERVICES LLC
Entity Type:Organization
Organization Name:OLDHAM HOSPICE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:STONEY
Authorized Official - Middle Name:
Authorized Official - Last Name:OLDHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-552-8066
Mailing Address - Street 1:PO BOX 396
Mailing Address - Street 2:
Mailing Address - City:STIGLER
Mailing Address - State:OK
Mailing Address - Zip Code:74462-0396
Mailing Address - Country:US
Mailing Address - Phone:918-552-8066
Mailing Address - Fax:918-967-9984
Practice Address - Street 1:519 E MAIN ST
Practice Address - Street 2:
Practice Address - City:STIGLER
Practice Address - State:OK
Practice Address - Zip Code:74462-2435
Practice Address - Country:US
Practice Address - Phone:918-552-8066
Practice Address - Fax:918-967-9984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based