Kiamichi Family Medical Center Inc. | |
6026 Battiest Pickens Rd Broken Bow OK 74728-5033 | |
(580) 241-5294 | |
(580) 241-5739 |
Full Name | Kiamichi Family Medical Center Inc. |
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Speciality | Clinic/Center |
Location | 6026 Battiest Pickens Rd, Broken Bow, Oklahoma |
Authorized Official Name and Position | Amy Gilbreath (CEO) |
Authorized Official Contact | 5802415294 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kiamichi Family Medical Center Inc. Po Box 180 Battiest OK 74722-0180 Ph: (580) 241-5294 | Kiamichi Family Medical Center Inc. 6026 Battiest Pickens Rd Broken Bow OK 74728-5033 Ph: (580) 241-5294 |
NPI Number | 1134138720 |
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Provider Enumeration Date | 08/05/2006 |
Last Update Date | 09/03/2015 |
Medicare PECOS PAC ID | 7315855541 |
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Medicare Enrollment ID | O20021212000008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134138720 | NPI | - | NPPES |
200003420A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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