Provider Demographics
NPI:1801405816
Name:LOVING SHEPARD
Entity Type:Organization
Organization Name:LOVING SHEPARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUCHENGUETI
Authorized Official - Middle Name:SHEPARD
Authorized Official - Last Name:CHABIKWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-202-5825
Mailing Address - Street 1:3555 NW 58TH ST STE 350
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4723
Mailing Address - Country:US
Mailing Address - Phone:405-202-5825
Mailing Address - Fax:
Practice Address - Street 1:3555 NW 58TH ST STE 350
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4723
Practice Address - Country:US
Practice Address - Phone:405-202-5825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-26
Last Update Date:2020-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care