Provider Demographics
NPI:1467463810
Name:OSAGE NATION ENTERPRISES, INC.
Entity type:Organization
Organization Name:OSAGE NATION ENTERPRISES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BOARD CHAIR
Authorized Official - Prefix:
Authorized Official - First Name:NICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:LORENZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-287-5645
Mailing Address - Street 1:213 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:PAWHUSKA
Mailing Address - State:OK
Mailing Address - Zip Code:74056-4205
Mailing Address - Country:US
Mailing Address - Phone:918-287-5645
Mailing Address - Fax:918-287-9909
Practice Address - Street 1:213 E 6TH ST
Practice Address - Street 2:
Practice Address - City:PAWHUSKA
Practice Address - State:OK
Practice Address - Zip Code:74056-4205
Practice Address - Country:US
Practice Address - Phone:918-287-5645
Practice Address - Fax:918-287-9909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7339251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK37D1030161OtherCLIA IDN
OK37D1030161OtherCLIA IDN
OK377509Medicare ID - Type Unspecified