| Lchc Eastside | |
|
1102 Se 36th St Lawton OK 73501-8462 | |
| (580) 585-5550 | |
| (580) 585-5551 |
| Full Name | Lchc Eastside |
|---|---|
| Speciality | Clinic/Center |
| Location | 1102 Se 36th St, Lawton, Oklahoma |
| Authorized Official Name and Position | Brent Smith (CHIEF EXECTIVE OFFICER) |
| Authorized Official Contact | 5803558620 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lchc Eastside Po Box 2309 Section 2 Lawton OK 73502-2309 Ph: (580) 357-9984 | Lchc Eastside 1102 Se 36th St Lawton OK 73501-8462 Ph: (580) 585-5550 |
| NPI Number | 1851839096 |
|---|---|
| Provider Enumeration Date | 02/08/2017 |
| Last Update Date | 03/14/2017 |
| Medicare PECOS PAC ID | 2668373689 |
|---|---|
| Medicare Enrollment ID | O20170509001407 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851839096 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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