Provider Demographics
NPI:1629213889
Name:HOMETOWN QUALITY CARE, INC
Entity Type:Organization
Organization Name:HOMETOWN QUALITY CARE, INC
Other - Org Name:ACCENTRA HOME HEALTH - SOUTHEASTERN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CCO
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:BEARD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:405-840-7775
Mailing Address - Street 1:2028 E MEMORIAL RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5515
Mailing Address - Country:US
Mailing Address - Phone:405-840-7775
Mailing Address - Fax:405-840-7776
Practice Address - Street 1:191475 N 4140 RD STE 3
Practice Address - Street 2:
Practice Address - City:ANTLERS
Practice Address - State:OK
Practice Address - Zip Code:74523-7587
Practice Address - Country:US
Practice Address - Phone:580-298-2000
Practice Address - Fax:580-298-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-02
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7899251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200391290AMedicaid
OK377736Medicare Oscar/Certification