| Neohealth | |
|
1500 E Downing St Suite 208 Tahlequah OK 74464-3234 | |
| (918) 456-2496 | |
| (918) 456-7108 |
| Full Name | Neohealth |
|---|---|
| Speciality | Clinic/Center |
| Location | 1500 E Downing St, Tahlequah, 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 |
|---|---|
| Neohealth Po Box 751 Hulbert OK 74441-0751 Ph: (918) 772-3390 | Neohealth 1500 E Downing St Suite 208 Tahlequah OK 74464-3234 Ph: (918) 456-2496 |
| NPI Number | 1184926362 |
|---|---|
| Provider Enumeration Date | 11/22/2010 |
| Last Update Date | 06/09/2020 |
| Medicare PECOS PAC ID | 3678482635 |
|---|---|
| Medicare Enrollment ID | O20110503000820 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184926362 | NPI | - | NPPES |
| 200006960E | Medicaid | OK | |
| 200006960J | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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