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26300 S Highway 125 Afton OK 74331-6282 | |
(918) 257-8585 | |
(918) 257-8560 |
Full Name | |
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Speciality | Clinic/center |
Location | 26300 S Highway 125, Afton, Oklahoma |
Authorized Official Name and Position | Herbert F. Crum (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 9182567551 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 326 Vinita OK 74301-0326 Ph: (918) 256-7551 | 26300 S Highway 125 Afton OK 74331-6282 Ph: (918) 257-8585 |
NPI Number | 1265602056 |
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Provider Enumeration Date | 03/07/2008 |
Last Update Date | 03/03/2015 |
Identifier | Type | State | Issuer |
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1265602056 | NPI | - | NPPES |
100261400K | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 2182 (Oklahoma) | Primary |
282NR1301X | General Acute Care Hospital - Rural | 2182 (Oklahoma) | Secondary |
In Home 2 Heal Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 56296 E 285 Rd Ste A, Afton, OK 74331 Phone: 918-219-9189 | |