| East Central Oklahoma Family Health Center, Inc. | |
|
104 E Shurden Industrial Blvd Henryetta OK 74437-7323 | |
| (918) 652-9614 | |
| (918) 652-4831 |
| Full Name | East Central Oklahoma Family Health Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 104 E Shurden Industrial Blvd, 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. Po Box 236 Wetumka OK 74883-0236 Ph: (405) 452-3151 | East Central Oklahoma Family Health Center, Inc. 104 E Shurden Industrial Blvd Henryetta OK 74437-7323 Ph: (918) 652-9614 |
| NPI Number | 1881943389 |
|---|---|
| Provider Enumeration Date | 08/30/2012 |
| Last Update Date | 02/26/2019 |
| Medicare PECOS PAC ID | 3779643994 |
|---|---|
| Medicare Enrollment ID | O20130328000366 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881943389 | NPI | - | NPPES |
| 371886 | Other | OK | MEDICARE CCN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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