Provider Demographics
NPI:1932359023
Name:INSYNC LIFE CARE, LLC
Entity Type:Organization
Organization Name:INSYNC LIFE CARE, LLC
Other - Org Name:INSYNC RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BRAZEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-551-6879
Mailing Address - Street 1:1515 E 71ST ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-5046
Mailing Address - Country:US
Mailing Address - Phone:918-582-7500
Mailing Address - Fax:918-728-2340
Practice Address - Street 1:1515 E 71ST ST
Practice Address - Street 2:SUITE 100
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-5046
Practice Address - Country:US
Practice Address - Phone:918-582-7500
Practice Address - Fax:918-728-2340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2-67453336C0003X
364S00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGroup - Single Specialty