Elevation Health Llc | |
1745 W 33rd St Edmond OK 73013-3831 | |
(406) 309-4780 | |
Not Available |
Full Name | Elevation Health Llc |
---|---|
Speciality | Clinic/Center |
Location | 1745 W 33rd St, Edmond, Oklahoma |
Authorized Official Name and Position | Charles Tate Woodward (PHYSICIAN/OWNER) |
Authorized Official Contact | 4063094780 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Elevation Health Llc 1745 W 33rd St Edmond OK 73013-3831 Ph: (406) 309-4780 | Elevation Health Llc 1745 W 33rd St Edmond OK 73013-3831 Ph: (406) 309-4780 |
NPI Number | 1841077807 |
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Provider Enumeration Date | 09/13/2023 |
Last Update Date | 10/04/2024 |
Certification Date | 10/04/2024 |
Medicare PECOS PAC ID | 4486098019 |
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Medicare Enrollment ID | O20240222000163 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841077807 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Charles Tate Woodward |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1760606917 PECOS PAC ID: 5395839294 Enrollment ID: I20190130002827 |
Provider Name | Sarah Anwar |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1982263554 PECOS PAC ID: 6406184076 Enrollment ID: I20231214002678 |
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