| Poteau Community Care | |
|
1301 S Broadway Ave Ste 2 Poteau OK 74953-5268 | |
| (918) 564-2010 | |
| (918) 564-2080 |
| Full Name | Poteau Community Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 1301 S Broadway Ave Ste 2, Poteau, Oklahoma |
| Authorized Official Name and Position | Steve Young (CEO) |
| Authorized Official Contact | 9185642010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Poteau Community Care 107 E Dora Ln Poteau OK 74953-5518 Ph: (191) 883-9969 | Poteau Community Care 1301 S Broadway Ave Ste 2 Poteau OK 74953-5268 Ph: (918) 564-2010 |
| NPI Number | 1871108514 |
|---|---|
| Provider Enumeration Date | 09/10/2020 |
| Last Update Date | 01/16/2023 |
| Medicare PECOS PAC ID | 3274943386 |
|---|---|
| Medicare Enrollment ID | O20201030001858 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871108514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Tabitha Rena Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649885443 PECOS PAC ID: 4183034291 Enrollment ID: I20201030002198 |
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