| Community Health Connection Kw | |
|
2321 E 3rd Street Tulsa OK 74104 | |
| (918) 622-0641 | |
| (918) 622-4814 |
| Full Name | Community Health Connection Kw |
|---|---|
| Speciality | Clinic/Center |
| Location | 2321 E 3rd Street, Tulsa, Oklahoma |
| Authorized Official Name and Position | Jeff Faust (HR MANAGER) |
| Authorized Official Contact | 9186220641 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Connection Kw 2321 E 3rd Street Tulsa OK 74104 Ph: (918) 622-0641 | Community Health Connection Kw 2321 E 3rd Street Tulsa OK 74104 Ph: (918) 622-0641 |
| NPI Number | 1255612040 |
|---|---|
| Provider Enumeration Date | 09/07/2011 |
| Last Update Date | 09/20/2016 |
| Medicare PECOS PAC ID | 5991756397 |
|---|---|
| Medicare Enrollment ID | O20111107000495 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255612040 | NPI | - | NPPES |
| 200082520B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Oklahoma) | Primary |
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