| East Central Oklahoma Family Health Center, Inc. | |
|
1102 West Main Street Henryetta OK 74437 | |
| (918) 652-9615 | |
| (918) 652-7612 |
| Full Name | East Central Oklahoma Family Health Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1102 West Main Street, Henryetta, Oklahoma |
| Authorized Official Name and Position | Donna Dyer (CEO) |
| Authorized Official Contact | 4054523151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Central Oklahoma Family Health Center, Inc. P.o. Box 236 Wetumka OK 74883 Ph: (405) 452-3151 | East Central Oklahoma Family Health Center, Inc. 1102 West Main Street Henryetta OK 74437 Ph: (918) 652-9615 |
| NPI Number | 1639636657 |
|---|---|
| Provider Enumeration Date | 02/26/2019 |
| Last Update Date | 09/14/2023 |
| Medicare PECOS PAC ID | 3779643994 |
|---|---|
| Medicare Enrollment ID | O20240109003202 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639636657 | NPI | - | NPPES |
| 200235450F | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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