Variety Care Mid-del | |
3851 Tinker Diag St Del City OK 73115-2109 | |
(405) 632-6688 | |
(405) 677-8991 |
Full Name | Variety Care Mid-del |
---|---|
Speciality | Clinic/Center |
Location | 3851 Tinker Diag St, Del City, Oklahoma |
Authorized Official Name and Position | Tim Reddout (CFO) |
Authorized Official Contact | 4056326688 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Variety Care Mid-del 3000 N Grand Blvd Oklahoma City OK 73107-1818 Ph: (405) 632-6688 | Variety Care Mid-del 3851 Tinker Diag St Del City OK 73115-2109 Ph: (405) 632-6688 |
NPI Number | 1568591477 |
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Provider Enumeration Date | 03/05/2007 |
Last Update Date | 02/26/2020 |
Medicare PECOS PAC ID | 1557260007 |
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Medicare Enrollment ID | O20091111000380 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568591477 | NPI | - | NPPES |
100728770 E | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Oklahoma) | Primary |
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