- Enrollment id
- O20250918000834
- Enrollment state
- OK
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1386883361
- Multiple npi flag
- N
- Ccn
- 371660
- Associate id
- 6901300425
- Organization name
- ANTHEM HOSPICE OF OKLAHOMA CITY LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 425 W WILSHIRE BLVD
- Address line 2
- STE C
- City
- OKLAHOMA CITY
- State
- OK
- Zip code
- 731167794