Triton Health Elder Care Llc | |
305 N Thornton St Vian OK 74962-5088 | |
(918) 773-5228 | |
Not Available |
Full Name | Triton Health Elder Care Llc |
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Speciality | Family Medicine |
Location | 305 N Thornton St, Vian, Oklahoma |
Authorized Official Name and Position | Cary Patrick Sullivan (MD/OWNER) |
Authorized Official Contact | 9187735228 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Triton Health Elder Care Llc Po Box 446 Vian OK 74962-0446 Ph: () - | Triton Health Elder Care Llc 305 N Thornton St Vian OK 74962-5088 Ph: (918) 773-5228 |
NPI Number | 1619710787 |
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Provider Enumeration Date | 06/17/2024 |
Last Update Date | 06/17/2024 |
Medicare PECOS PAC ID | 4082154927 |
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Medicare Enrollment ID | O20240906001607 |
Identifier | Type | State | Issuer |
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1619710787 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Cary P Sullivan |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1497701130 PECOS PAC ID: 4688686637 Enrollment ID: I20060614000309 |
Provider Name | Wanda Sue Choate |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356896856 PECOS PAC ID: 4587943279 Enrollment ID: I20161121001973 |
C. Patrick Sullivan,do Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 North Thornton, Vian, OK 74962 Phone: 918-773-5228 Fax: 918-773-8482 | |
Triton Health Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 128 W. Main Street, Vian, OK 74962 Phone: 918-773-5228 Fax: 918-773-8482 | |