Provider Demographics
NPI:1417233404
Name:PROCARE HEALING CENTERS
Entity Type:Organization
Organization Name:PROCARE HEALING CENTERS
Other - Org Name:CIARA MEDICAL EQUIPMENT COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVILLIERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:405-608-0350
Mailing Address - Street 1:11425 E 20TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74128-6438
Mailing Address - Country:US
Mailing Address - Phone:405-608-0350
Mailing Address - Fax:
Practice Address - Street 1:11425 E 20TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74128-6438
Practice Address - Country:US
Practice Address - Phone:405-608-0350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-23
Last Update Date:2011-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies