Provider Demographics
NPI:1457450462
Name:PROCARE HEALING CENTERS, LLP
Entity Type:Organization
Organization Name:PROCARE HEALING CENTERS, LLP
Other - Org Name:CIARA MEDICAL EQUIPMENT CO.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:S
Authorized Official - Last Name:DEVILLIERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:405-608-0350
Mailing Address - Street 1:2100 E BRITTON RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73131-3521
Mailing Address - Country:US
Mailing Address - Phone:405-608-0350
Mailing Address - Fax:405-608-0349
Practice Address - Street 1:2100 E BRITTON RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73131
Practice Address - Country:US
Practice Address - Phone:405-608-0350
Practice Address - Fax:405-608-0349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200111890AMedicaid
OK5841410001Medicare NSC