Provider Demographics
NPI:1619115896
Name:ACCENTRA HOME HEALTHCARE
Entity Type:Organization
Organization Name:ACCENTRA HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-488-2222
Mailing Address - Street 1:4350 WILL ROGERS PARKWAY
Mailing Address - Street 2:#500
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73108
Mailing Address - Country:US
Mailing Address - Phone:888-640-3907
Mailing Address - Fax:866-571-7532
Practice Address - Street 1:7611 STATE LINE RD
Practice Address - Street 2:#200
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-6801
Practice Address - Country:US
Practice Address - Phone:888-640-3907
Practice Address - Fax:866-571-7532
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACCENTRA HOME HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251E00000X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health