| New Hope Wellness Center | |
|
2809 Nw 31st St Oklahoma City OK 73112-7406 | |
| (405) 730-0771 | |
| (405) 768-2262 |
| Full Name | New Hope Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2809 Nw 31st St, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Theodore H Noel (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4057330771 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Hope Wellness Center 1420 Ne 23rd St Oklahoma City OK 73111-3004 Ph: (405) 733-0771 | New Hope Wellness Center 2809 Nw 31st St Oklahoma City OK 73112-7406 Ph: (405) 730-0771 |
| NPI Number | 1720414162 |
|---|---|
| Provider Enumeration Date | 09/17/2013 |
| Last Update Date | 09/25/2020 |
| Medicare PECOS PAC ID | 2961816558 |
|---|---|
| Medicare Enrollment ID | O20210121002175 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720414162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Charlyce Erin Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144360256 PECOS PAC ID: 7315047206 Enrollment ID: I20070706000227 |
| Provider Name | Jennifer Le |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689233272 PECOS PAC ID: 1052733953 Enrollment ID: I20200623001810 |
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