Provider Demographics
NPI:1982691606
Name:PANHANDLE HOME HEALTH & HOSPICE, INC.
Entity Type:Organization
Organization Name:PANHANDLE HOME HEALTH & HOSPICE, INC.
Other - Org Name:GUYMON HOME HEALTH & HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-338-2274
Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:
Mailing Address - City:GUYMON
Mailing Address - State:OK
Mailing Address - Zip Code:73942-0547
Mailing Address - Country:US
Mailing Address - Phone:580-338-2274
Mailing Address - Fax:580-338-2143
Practice Address - Street 1:1203 N ELLISON ST
Practice Address - Street 2:
Practice Address - City:GUYMON
Practice Address - State:OK
Practice Address - Zip Code:73942-3657
Practice Address - Country:US
Practice Address - Phone:580-338-2274
Practice Address - Fax:580-338-2143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7042251E00000X
OK4051251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK371545Medicare ID - Type UnspecifiedHOSPICE
OK377248Medicare ID - Type UnspecifiedHOME HEALTH