Provider Demographics
NPI:1407645583
Name:EAGLET HEALTH LLC
Entity type:Organization
Organization Name:EAGLET HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/ MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:405-604-7498
Mailing Address - Street 1:4401 W MEMORIAL RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1785
Mailing Address - Country:US
Mailing Address - Phone:405-604-7498
Mailing Address - Fax:
Practice Address - Street 1:4401 W MEMORIAL RD STE 135
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-1787
Practice Address - Country:US
Practice Address - Phone:405-442-7577
Practice Address - Fax:405-442-7223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy