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118 S Louis Tittle Ave Mangum OK 73554-4441 | |
(580) 782-2000 | |
(580) 782-5906 |
Full Name | |
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Speciality | Clinic/Center |
Location | 118 S Louis Tittle Ave, Mangum, Oklahoma |
Authorized Official Name and Position | Andrea Snider (CONTROLLER) |
Authorized Official Contact | 5807823353 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 280 Mangum OK 73554-0280 Ph: (580) 782-2000 | 118 S Louis Tittle Ave Mangum OK 73554-4441 Ph: (580) 782-2000 |
NPI Number | 1568978708 |
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Provider Enumeration Date | 12/26/2017 |
Last Update Date | 10/06/2020 |
Medicare PECOS PAC ID | 6305119942 |
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Medicare Enrollment ID | O20191120000442 |
Identifier | Type | State | Issuer |
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1568978708 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Quartz Mountian Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 118 S Louis Tittle Ave, Mangum, OK 73554 Phone: 580-782-2113 Fax: 580-782-5944 |