Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 315 W. 9th, Weleetka, Oklahoma |
Authorized Official Name and Position | Jan Parker (MANAGER) |
Authorized Official Contact | 4057862248 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 337 Weleetka OK 74880-0337 Ph: (405) 786-2248 | 315 W. 9th Weleetka OK 74880 Ph: (405) 786-2248 |
NPI Number | 1699953687 |
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Provider Enumeration Date | 02/01/2008 |
Last Update Date | 09/28/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1699953687 | NPI | - | NPPES |
100743630B | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 373819 (Oklahoma) | Primary |