| Community Health Connection | |
|
9912 E 21st St Tulsa OK 74129-1620 | |
| (918) 622-0641 | |
| (918) 622-4814 |
| Full Name | Community Health Connection |
|---|---|
| Speciality | Clinic/Center |
| Location | 9912 E 21st St, Tulsa, Oklahoma |
| Authorized Official Name and Position | Tracy R Hiscock (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 9912 E 21st St Tulsa OK 74129-1620 Ph: (918) 622-0641 | Community Health Connection 9912 E 21st St Tulsa OK 74129-1620 Ph: (918) 622-0641 |
| NPI Number | 1194730911 |
|---|---|
| Provider Enumeration Date | 07/30/2006 |
| Last Update Date | 08/25/2011 |
| Medicare PECOS PAC ID | 5991756397 |
|---|---|
| Medicare Enrollment ID | O20060831000413 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194730911 | NPI | - | NPPES |
| 200082520A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Oklahoma) | Primary |
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