Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 104 N Hibbs, Turpin, Oklahoma |
Authorized Official Name and Position | Brent Meyers (ADMINISTRATOR) |
Authorized Official Contact | 5806254551 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 299 Turpin OK 73950-0299 Ph: (580) 778-3966 | 104 N Hibbs Turpin OK 73950-0299 Ph: (580) 778-3966 |
NPI Number | 1285611756 |
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Provider Enumeration Date | 12/27/2005 |
Last Update Date | 08/13/2008 |
Medicare PECOS PAC ID | 9335134246 |
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Medicare Enrollment ID | O20080616000043 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285611756 | NPI | - | NPPES |
100700760G | Medicaid | OK | |
100700760H | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 2242 (Oklahoma) | Primary |