| Central Oklahoma Family Medical Center, Inc | |
|
905 Colony Drive Bldg Ada OK 74820 | |
| (580) 925-3286 | |
| Not Available |
| Full Name | Central Oklahoma Family Medical Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 905 Colony Drive Bldg, Ada, Oklahoma |
| Authorized Official Name and Position | Brenda Ware (CEO) |
| Authorized Official Contact | 5809253286 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Oklahoma Family Medical Center, Inc 527 W 3rd St Konawa OK 74849-1415 Ph: (580) 925-3286 | Central Oklahoma Family Medical Center, Inc 905 Colony Drive Bldg Ada OK 74820 Ph: (580) 925-3286 |
| NPI Number | 1063988673 |
|---|---|
| Provider Enumeration Date | 10/22/2018 |
| Last Update Date | 10/22/2018 |
| Medicare PECOS PAC ID | 9931189685 |
|---|---|
| Medicare Enrollment ID | O20190228002696 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063988673 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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