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415 6th Street Boswell OK 74727-0149 | |
(580) 566-2530 | |
(580) 566-2533 |
Full Name | |
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Speciality | Clinic/Center |
Location | 415 6th Street, Boswell, Oklahoma |
Authorized Official Name and Position | Angela R Batton (CEO) |
Authorized Official Contact | 9185694143 |
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 219 Clayton OK 74536-0219 Ph: (918) 569-4143 | 415 6th Street Boswell OK 74727-0149 Ph: (580) 566-2530 |
NPI Number | 1487193819 |
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Provider Enumeration Date | 02/17/2017 |
Last Update Date | 02/17/2017 |
Medicare PECOS PAC ID | 9537189261 |
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Medicare Enrollment ID | O20160701000430 |
Identifier | Type | State | Issuer |
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1487193819 | NPI | - | NPPES |
200072150E | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |