Provider Demographics
NPI:1710984844
Name:3D HEALTH CARE, INC.
Entity Type:Organization
Organization Name:3D HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR/SUPERVISING NURSE
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SPEARS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:918-465-9001
Mailing Address - Street 1:116 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILBURTON
Mailing Address - State:OK
Mailing Address - Zip Code:74578-4044
Mailing Address - Country:US
Mailing Address - Phone:918-465-9001
Mailing Address - Fax:918-465-9004
Practice Address - Street 1:116 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WILBURTON
Practice Address - State:OK
Practice Address - Zip Code:74578-4044
Practice Address - Country:US
Practice Address - Phone:918-465-9001
Practice Address - Fax:918-465-9004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKHC7776251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKHC7776OtherSTATE LICENSURE NUMBER
OK37-7672Medicare ID - Type Unspecified