Provider Demographics
NPI:1184784563
Name:OLDER CITIZENS SERVICES INC
Entity type:Organization
Organization Name:OLDER CITIZENS SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-534-1270
Mailing Address - Street 1:300 E ANGUS AVE
Mailing Address - Street 2:
Mailing Address - City:DEWEY
Mailing Address - State:OK
Mailing Address - Zip Code:74029-2706
Mailing Address - Country:US
Mailing Address - Phone:918-534-1270
Mailing Address - Fax:918-534-1606
Practice Address - Street 1:300 E ANGUS AVE
Practice Address - Street 2:
Practice Address - City:DEWEY
Practice Address - State:OK
Practice Address - Zip Code:74029-2706
Practice Address - Country:US
Practice Address - Phone:918-534-1270
Practice Address - Fax:918-534-1606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100683580 AOtherMEAL DELIVERY