Provider Demographics
NPI:1881674620
Name:EXCELL HOME CARE & HOSPICE INC
Entity Type:Organization
Organization Name:EXCELL HOME CARE & HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MINA
Authorized Official - Middle Name:B
Authorized Official - Last Name:ACQUAYE
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN MPH CHCE
Authorized Official - Phone:405-631-0521
Mailing Address - Street 1:1200 SW 104TH ST
Mailing Address - Street 2:STE D
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139
Mailing Address - Country:US
Mailing Address - Phone:405-631-0521
Mailing Address - Fax:405-631-2661
Practice Address - Street 1:1200 SW 104TH ST
Practice Address - Street 2:STE D
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139
Practice Address - Country:US
Practice Address - Phone:405-631-0521
Practice Address - Fax:405-631-2661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4151251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK371610Medicare Oscar/Certification