Provider Demographics
NPI:1255478186
Name:INFINITY CARE HOSPICE LLC
Entity type:Organization
Organization Name:INFINITY CARE HOSPICE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BRAZEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-392-0800
Mailing Address - Street 1:6914 S YORKTOWN AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3900
Mailing Address - Country:US
Mailing Address - Phone:918-392-0800
Mailing Address - Fax:918-392-0808
Practice Address - Street 1:6914 S YORKTOWN AVE STE 115
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-3900
Practice Address - Country:US
Practice Address - Phone:918-392-0800
Practice Address - Fax:918-392-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK371639Medicare Oscar/Certification