Lchc Apache Clinic | |
1102 South Cobb Lake Street Apache OK 73006 | |
(580) 588-3257 | |
(580) 588-3265 |
Full Name | Lchc Apache Clinic |
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Speciality | Clinic/Center |
Location | 1102 South Cobb Lake Street, Apache, Oklahoma |
Authorized Official Name and Position | Brent Smith (CEO) |
Authorized Official Contact | 5803558620 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lchc Apache Clinic 3401 W Gore Blvd Lawton OK 73505-6332 Ph: (580) 585-5443 | Lchc Apache Clinic 1102 South Cobb Lake Street Apache OK 73006 Ph: (580) 588-3257 |
NPI Number | 1609897461 |
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Provider Enumeration Date | 07/21/2006 |
Last Update Date | 01/10/2024 |
Medicare PECOS PAC ID | 2668373689 |
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Medicare Enrollment ID | O20200930000556 |
Identifier | Type | State | Issuer |
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1609897461 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | 16693 (Oklahoma) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |