FacilityDetail

Last Updated:  12/22/2024 5:22:09 AM

Facility Detail                       
Corporation / Company Owner Name  
Business (DBA) Name   HOSPICE SOURCE LLC 
License Number  1-S-5688 
Facility Type Medical Gas Supplier 
Address

4311 S PROSPECT AVENUE

City, State, Zip OKLAHOMA CITY,OK 73129 
Country   
Issue Date  10/26/2018 
Renewed Date 10/07/2022
Expiration Date  10/31/2023 
Renewal Month
End Date  03/10/2023 
Status CLOSED 
In Process?
 

Disciplinary Action
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Case Date   Case Number  
No records 
 

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