| Onyx Health & Wellness, Llc | |
|
6520 E Reno Ave Ste D Midwest City OK 73110-2119 | |
| (405) 455-3008 | |
| Not Available |
| Full Name | Onyx Health & Wellness, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6520 E Reno Ave Ste D, Midwest City, Oklahoma |
| Authorized Official Name and Position | Anataya Rucker (NURSE PRACTITIONER/OWNER) |
| Authorized Official Contact | 4053144451 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Onyx Health & Wellness, Llc Po Box 52 Spencer OK 73084-0052 Ph: (405) 314-4451 | Onyx Health & Wellness, Llc 6520 E Reno Ave Ste D Midwest City OK 73110-2119 Ph: (405) 455-3008 |
| NPI Number | 1811686116 |
|---|---|
| Provider Enumeration Date | 05/02/2023 |
| Last Update Date | 01/21/2024 |
| Medicare PECOS PAC ID | 2466807615 |
|---|---|
| Medicare Enrollment ID | O20231009002494 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811686116 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Anataya Rachi Rucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144702424 PECOS PAC ID: 5799118964 Enrollment ID: I20191202000129 |
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