Provider Demographics
NPI:1184488868
Name:PHENYX HOME CARE LLC
Entity type:Organization
Organization Name:PHENYX HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CO-CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUTHERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:580-647-0792
Mailing Address - Street 1:6425 NW CACHE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-3391
Mailing Address - Country:US
Mailing Address - Phone:580-699-3094
Mailing Address - Fax:580-699-3093
Practice Address - Street 1:6425 NW CACHE RD STE 102
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-3391
Practice Address - Country:US
Practice Address - Phone:580-699-3094
Practice Address - Fax:580-699-3093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health