Provider Demographics
NPI:1841167939
Name:GREEN COUNTRY HEALTH INNOVATIONS, INC
Entity type:Organization
Organization Name:GREEN COUNTRY HEALTH INNOVATIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:G
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:HCA
Authorized Official - Phone:918-747-2273
Mailing Address - Street 1:3501 SOUTH YALE AVENUE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-8014
Mailing Address - Country:US
Mailing Address - Phone:918-747-2273
Mailing Address - Fax:918-747-2573
Practice Address - Street 1:3501 SOUTH YALE AVENUE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-8014
Practice Address - Country:US
Practice Address - Phone:918-747-2273
Practice Address - Fax:918-747-2573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care