| Advanced Caliber Enterprise Llc | |
|
148 W Main St Ste F Glenpool OK 74033-3952 | |
| (918) 938-0533 | |
| (918) 938-0547 |
| Full Name | Advanced Caliber Enterprise Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 148 W Main St Ste F, Glenpool, Oklahoma |
| Authorized Official Name and Position | Jamie Jarvis (OWNER) |
| Authorized Official Contact | 9182084907 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Caliber Enterprise Llc 148 W Main St Ste F Glenpool OK 74033-3952 Ph: (918) 938-0533 | Advanced Caliber Enterprise Llc 148 W Main St Ste F Glenpool OK 74033-3952 Ph: (918) 938-0533 |
| NPI Number | 1750126074 |
|---|---|
| Provider Enumeration Date | 06/27/2024 |
| Last Update Date | 06/27/2024 |
| Medicare PECOS PAC ID | 7911442009 |
|---|---|
| Medicare Enrollment ID | O20240712002789 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750126074 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Jamie Jarvis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689414187 PECOS PAC ID: 8820533912 Enrollment ID: I20240712002926 |
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