| Lchc Southcare | |
|
512 Sw Lee Blvd Lawton OK 73501-5711 | |
| (580) 250-6541 | |
| (580) 250-6543 |
| Full Name | Lchc Southcare |
|---|---|
| Speciality | Clinic/Center |
| Location | 512 Sw Lee Blvd, Lawton, Oklahoma |
| Authorized Official Name and Position | Brent Smith (CEO) |
| Authorized Official Contact | 5805855522 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lchc Southcare Po Box 785 Lawton OK 73502-0785 Ph: (580) 357-9984 | Lchc Southcare 512 Sw Lee Blvd Lawton OK 73501-5711 Ph: (580) 250-6541 |
| NPI Number | 1588351407 |
|---|---|
| Provider Enumeration Date | 04/20/2023 |
| Last Update Date | 04/20/2023 |
| Medicare PECOS PAC ID | 2668373689 |
|---|---|
| Medicare Enrollment ID | O20230613000204 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588351407 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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