Provider Demographics
NPI:1801997812
Name:ONHL MEDICAL HOME HEALTH SERVICES
Entity type:Organization
Organization Name:ONHL MEDICAL HOME HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGREW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-775-4439
Mailing Address - Street 1:PO BOX 1216
Mailing Address - Street 2:
Mailing Address - City:DRUMRIGHT
Mailing Address - State:OK
Mailing Address - Zip Code:74030-1216
Mailing Address - Country:US
Mailing Address - Phone:918-352-9220
Mailing Address - Fax:918-352-9220
Practice Address - Street 1:124 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:DRUMRIGHT
Practice Address - State:OK
Practice Address - Zip Code:74030-3802
Practice Address - Country:US
Practice Address - Phone:918-352-9220
Practice Address - Fax:918-352-9626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLICENSE#251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK377700Medicare Oscar/Certification