Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 40 Hospital Rd, Fairfax, Oklahoma |
Authorized Official Name and Position | Tina J Steele (CEO) |
Authorized Official Contact | 9186423291 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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40 Hospital Rd Fairfax OK 74637-5084 Ph: (918) 642-3291 | 40 Hospital Rd Fairfax OK 74637 Ph: (918) 642-8827 |
NPI Number | 1306145339 |
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Provider Enumeration Date | 03/16/2011 |
Last Update Date | 07/16/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306145339 | NPI | - | NPPES |
200311270C | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 2274 (Oklahoma) | Primary |