Provider Demographics
NPI:1043317399
Name:SEQUOYAH HOSPICE INC.
Entity type:Organization
Organization Name:SEQUOYAH HOSPICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:KAYE
Authorized Official - Middle Name:K
Authorized Official - Last Name:ESTES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:918-647-7829
Mailing Address - Street 1:17 E CARL ALBERT PKWY
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-5037
Mailing Address - Country:US
Mailing Address - Phone:918-302-0533
Mailing Address - Fax:918-302-0537
Practice Address - Street 1:17 E CARL ALBERT PKWY
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5037
Practice Address - Country:US
Practice Address - Phone:918-302-0533
Practice Address - Fax:918-302-0537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK371651251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK371651Medicare ID - Type UnspecifiedHOSPICE