INDIAN TERRITORY HOME HEALTH AND HOSPICE INC. (NPI# 1437256831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437256831 |
| Entity Type | Organization |
| Organization Name | INDIAN TERRITORY HOME HEALTH AND HOSPICE INC. |
| Other Organization Name | TISHOMINGO FAMILY MEDICAL CENTER |
| Practice Address |
512 E 24th St Tishomingo OK 73460-3214 |
| Mailing Address |
Po Box 176 Tishomingo OK 73460-0176 |
| Practice Telephone | 5803712394 |
| Practice Fax Number | 5803712638 |
| Mailing Telephone | 5803712394 |
| Mailing Fax Number | 5803712638 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-05-07 |
| Authorized Official Name | MR. TIM PAUL WIGINGTON (OWNER, ADMINISTRATOR) |
| Authorized Official Telephone | 5803712394 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 37D0472003 | OK | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | BC/BS | 730796180003 | 01 |
| OK | 100262450D | 05 |
| Other Name | Type Code |
|---|---|
| Tishomingo Family Medical Center | Doing Business As Name - Organization |
| Street Address |
512 E 24TH ST |
| City | TISHOMINGO |
| State | OK |
| Zip Code | 73460-3214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679684914 | Rhonda Jeanne Hendrix | Nurse Practitioner | 512 E 24th St, Tishomingo, OK 73460-3214 | 2006-08-31 |
| 1568000966 | Southern Oklahoma Treatment Services, Inc. | Community/Behavioral Health | 512 E 24th St, Tishomingo, OK 73460-3214 | 2019-12-16 |
| 1093299893 | Stacey Jean Loughridge | Counselor | 512 E 24th St, Tishomingo, OK 73460-3214 | 2018-09-18 |
| 1386169449 | Crystal Lynn Maldonado | Case Manager/Care Coordinator | 512 E 24th St, Tishomingo, OK 73460-3214 | 2017-08-10 |
| 1073996815 | Christina M Powell | Counselor | 512 E 24th St, Tishomingo, OK 73460-3214 | 2015-06-29 |
| 1346634227 | Yco Tulsa, Inc. | Clinic/Center | 512 E 24th St, Suites A and C, Tishomingo, OK 73460-3214 | 2015-03-27 |
| 1891110714 | Southeastern Oklahoma Family Services, Inc | Community/Behavioral Health | 512 E 24th St, Tishomingo, OK 73460-3214 | 2014-02-28 |
| 1447699905 | Jennifer Nicole Standridge | Counselor | 512 E 24th St, Tishomingo, OK 73460-3214 | 2013-06-18 |
| 1265703573 | Marion C Straub | Clinic/Center | 512 E 24th St, Tishomingo, OK 73460-3214 | 2012-01-18 |
| 1578830980 | Miranda Lee Frazer | Counselor | 512 E 24th St, Tishomingo, OK 73460 | 2011-11-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912380742 | Lori Pigg | Speech-Language Pathologist | 508 N. Neshoba, Tishomingo, OK 73460 | 2015-06-29 |
| 1407241748 | Brittany Walker | Case Management | 850 E. Highway 22, Tishomingo, OK 73460 | 2015-04-03 |
| 1427460641 | Elizabeth Mcdonald | Counselor | 512 East 24th, Tishomingo, OK 73460 | 2014-05-22 |
| 1619387131 | Sheri Slaughter | Counselor | 102 N. Neshoba, Tishomingo, OK 73460 | 2014-05-06 |
| 1336559848 | Heather Marlatt | Counselor | 102 North Neshoba, Tishomingo, OK 73460 | 2014-05-06 |
| 1811231939 | Wanda Luann Beesley Gray | Emergency Medical Technician, Paramedic | 3100 E St Hwy 78, Tishomingo, OK 73460 | 2012-11-15 |
| 1497014724 | Jessica Kay Johnston | Counselor | Outpatient Services-tishomingo; 817 E. 6th St., Strong Family Development, Tishomingo, OK 73460 | 2012-05-07 |
| 1487910949 | Rhonda Gayle Harrison | Counselor | 817 E. 6th St., Medical Family Therapy, Tishomingo, OK 73460 | 2012-04-09 |
| 1265704183 | Parks Family Dental | Preferred Provider Organization | 1520 E. Main Street, Tishomingo, OK 73460 | 2012-02-08 |
| 1770852295 | Gina Marice Frazier | Social Worker | Outpatient Services- Tishomingo, 817 E. 6th St., Tishomingo, OK 73460 | 2011-12-29 |
| Find all providers in zip 73460 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
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| 1790307395 | Arc Diagnostics, LLC | Clinical Medical Laboratory | 8551 N 125th East Ave Ste 150, Owasso, OK 74055-2110 | 2020-05-18 |
| 1487275699 | Stateline Medical Lab LLC | Clinical Medical Laboratory | 105 N Pocola Blvd Ste 2, Pocola, OK 74902-3101 | 2020-04-28 |
| 1417583162 | Imaginus Diagnostic Laboratory LLC | Clinical Medical Laboratory | 17673 Us Highway 271, Spiro, OK 74959-5300 | 2020-03-13 |
| 1366089633 | Wellness Labs, LLC | Clinical Medical Laboratory | 5272 S Lewis Ave Ste 120, Tulsa, OK 74105-6563 | 2019-12-05 |
| 1669021622 | National Laboratory Corporation | Clinical Medical Laboratory | 5805 E 15th St Ste 104, Tulsa, OK 74112-6401 | 2019-09-11 |
| 1720636806 | Axiom Biogenomics, LLC | Clinical Medical Laboratory | 7335 S Lewis Ave Ste 120, Tulsa, OK 74136-6830 | 2019-08-31 |
| 1881178010 | Progentec Diagnostics Inc. | Clinical Medical Laboratory | 825 Ne 13th St Ste Mc302.4, Oklahoma City, OK 73104-5005 | 2018-09-24 |
| 1891280541 | Wellness Federal Labs, LLC | Clinical Medical Laboratory | 5272 S Lewis Ave Ste 121, Tulsa, OK 74105-6563 | 2018-06-26 |
| Find all providers with the same taxonomy | ||||
| City | TISHOMINGO |
| Zip Code | 73460 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.