FacilityDetail

Last Updated:  12/22/2024 5:22:09 AM

Facility Detail                       
Corporation / Company Owner Name  
Business (DBA) Name   HOSPICE SOURCE 
License Number  1-G-8044 
Facility Type DME Supplier / Medical Gas Distributor 
Address

3920 NW 39TH ST STE G

City, State, Zip OKLAHOMA CITY,OK 73112 
Country   
Issue Date  06/21/2023 
Renewed Date 06/22/2023
Expiration Date  06/30/2024 
Renewal Month
End Date  08/01/2024 
Status CLOSED 
In Process?
 

Disciplinary Action
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Case Date   Case Number  
No records 
 

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