| Faith Health Center, Llc | |
|
10501 S Quebec Ave Tulsa OK 74137-6234 | |
| (918) 876-0606 | |
| (918) 876-0604 |
| Full Name | Faith Health Center, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 10501 S Quebec Ave, Tulsa, Oklahoma |
| Authorized Official Name and Position | Judy Wagga (OWNER) |
| Authorized Official Contact | 9188760606 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Faith Health Center, Llc Po Box 311 Jenks OK 74037-0311 Ph: (918) 876-0606 | Faith Health Center, Llc 10501 S Quebec Ave Tulsa OK 74137-6234 Ph: (918) 876-0606 |
| NPI Number | 1336811041 |
|---|---|
| Provider Enumeration Date | 09/30/2021 |
| Last Update Date | 09/30/2021 |
| Certification Date | 09/30/2021 |
| Medicare PECOS PAC ID | 7517365448 |
|---|---|
| Medicare Enrollment ID | O20211007001667 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336811041 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Judy K Wagga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720605595 PECOS PAC ID: 9638589583 Enrollment ID: I20201103003079 |
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