Full Name | |
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Speciality | Clinic/Center |
Location | 404 Main St, Velma, Oklahoma |
Authorized Official Name and Position | Douglas R Volinski (VICE PRESIDENT-FINANCE AND CFO) |
Authorized Official Contact | 5802518554 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 100 Duncan OK 73534-0100 Ph: (580) 251-8554 | 404 Main St Velma OK 73491 Ph: (580) 444-2630 |
NPI Number | 1124569744 |
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Provider Enumeration Date | 03/15/2017 |
Last Update Date | 03/15/2017 |
Medicare PECOS PAC ID | 5193613057 |
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Medicare Enrollment ID | O20170518000821 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124569744 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |