| |
5319 S Mill St Pryor OK 74361-6839 | |
(918) 772-3390 | |
(918) 772-2244 |
Full Name | |
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Speciality | Clinic/Center |
Location | 5319 S Mill St, Pryor, Oklahoma |
Authorized Official Name and Position | Scott Rosenthal (CEO) |
Authorized Official Contact | 9187723390 |
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 751 Hulbert OK 74441-0751 Ph: (918) 772-3390 | 5319 S Mill St Pryor OK 74361-6839 Ph: (918) 772-3390 |
NPI Number | 1669101184 |
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Provider Enumeration Date | 06/09/2022 |
Last Update Date | 06/17/2022 |
Medicare PECOS PAC ID | 3678482635 |
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Medicare Enrollment ID | O20220729000700 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669101184 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Mayes County Hmpn, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1301 Ne 1st St, Pryor, OK 74361 Phone: 918-824-7714 | |
S Bar D, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 109 N Fairland St Ste 109, Pryor, OK 74361 Phone: 918-825-3107 Fax: 918-825-3128 | |
Prophylaxis Healthcare Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 S Mill St, Pryor, OK 74361 Phone: 918-825-3777 Fax: 918-825-3776 | |