Provider Demographics
NPI:1609190776
Name:MYERS HOMECARE, INC.
Entity Type:Organization
Organization Name:MYERS HOMECARE, INC.
Other - Org Name:HEAVENLY HOSPICE AND HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:K
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-701-2536
Mailing Address - Street 1:3411 ROCK CREEK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-2465
Mailing Address - Country:US
Mailing Address - Phone:405-701-2536
Mailing Address - Fax:405-310-4044
Practice Address - Street 1:3411 ROCK CREEK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-2465
Practice Address - Country:US
Practice Address - Phone:405-701-2536
Practice Address - Fax:405-310-4044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-18
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKHO4272251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKHO4272OtherOKLAHOMA DEPARTMENT OF HEALTH HOSPICE LICENSE
OK371694Medicare UPIN