Provider Demographics
NPI:1497708713
Name:WOODWARD HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:WOODWARD HOME CARE SERVICES LLC
Other - Org Name:WOODWARD REGIONAL HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR BUSINESS OFFICE SUPPORT
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7466
Mailing Address - Street 1:1611 MAIN ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-3021
Mailing Address - Country:US
Mailing Address - Phone:580-254-9275
Mailing Address - Fax:580-254-3182
Practice Address - Street 1:1611 MAIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-3021
Practice Address - Country:US
Practice Address - Phone:580-254-9275
Practice Address - Fax:580-254-3182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
OK4037315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
371536Medicare Oscar/Certification