Provider Demographics
NPI:1437706504
Name:HOME MODS, PC
Entity Type:Organization
Organization Name:HOME MODS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ORCUTT
Authorized Official - Suffix:
Authorized Official - Credentials:OTR, SCEM, CAPS
Authorized Official - Phone:405-664-0956
Mailing Address - Street 1:1114 GROVER LN
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-5444
Mailing Address - Country:US
Mailing Address - Phone:405-664-0956
Mailing Address - Fax:405-701-0049
Practice Address - Street 1:1114 GROVER LN
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-5444
Practice Address - Country:US
Practice Address - Phone:405-664-0956
Practice Address - Fax:405-701-0049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-22
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health