EAST CENTRAL OKLAHOMA FAMILY HEALTH CENTER, INC. (NPI# 1093184145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093184145 |
Entity Type | Organization |
Organization Name | EAST CENTRAL OKLAHOMA FAMILY HEALTH CENTER, INC. |
Other Organization Name | EAST CENTRAL OKLAHOMA FAMILY HEALTH CENTER, INC. - WEWOKA |
Practice Address |
121 N. Mekusukey Avenue Wewoka OK 74884 |
Mailing Address |
Po Box 236 Wetumka OK 74883-0236 |
Practice Telephone | 4054525400 |
Practice Fax Number | 4054523310 |
Mailing Telephone | 4054523151 |
Mailing Fax Number | 4054523310 |
Enumeration Date | 2015-09-18 |
Last Update Date | 2016-01-21 |
Authorized Official Name | MRS. DONNA SUE DYER (CEO) |
Authorized Official Telephone | 4054523151 |
Authorized Official Credential | MSHR |
Is Organization Subpart | Y |
Parent Organization Name | EAST CENTRAL OKLAHOMA FAMILY HEALTH CENTER, INC. |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OK | 200235450E | 05 |
Other Name | Type Code |
---|---|
East Central Oklahoma Family Health Center, Inc. - Wewoka | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881943389 | East Central Oklahoma Family Health Center, Inc. | Clinic/Center | 104 E Shurden Industrial Blvd, Henryetta, OK 74437-7323 | 2012-08-30 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oklahoma Business Registrations | EAST CENTRAL OKLAHOMA FAMILY HEALTH CENTER, INC. | 109 S Main, Wetumka, OK 74883 |
Street Address |
121 N. MEKUSUKEY AVENUE |
City | WEWOKA |
State | OK |
Zip Code | 74884 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841798626 | Luvey Deatherage | Physician Assistant | 36640 Old Hwy 270, Wewoka, OK 74884 | 2018-01-26 |
1730604422 | Robert Adarme Montanez | Pharmacist | 36640 Hwy 270 Barking Water Rd, Wewoka, OK 74884 | 2017-08-03 |
1447788484 | Domika Kinman | Dental Hygienist | 36640 Highway 270, Wewoka, OK 74884 | 2017-06-02 |
1942737101 | Aaron Jahmal Johnson | Pharmacist | 36640 Hwy 270 and Barking Water Road, Wewoka, OK 74884 | 2017-05-18 |
1912434689 | Shannon Lowe | Pharmacist | 36640 Hwy 270 & Barkingwater Rd, Wewoka, OK 74884 | 2017-05-12 |
1225483522 | Indian Health Service-wewoka | Clinic/Center | Jct Hwys 56 & 270, Wewoka, OK 74884 | 2016-04-25 |
1841667441 | Chandler Hall | Dentist | Hwy 56 and 270 Jct, Wewoka, OK 74884 | 2015-08-31 |
1285989459 | Sherry Goines Loving | Counselor | 221 N. Wewoka Ave, Wewoka, OK 74884 | 2012-07-13 |
1053681346 | Misty Smith | Dental Hygienist | Hwy 270 & 56 Jct, Wewoka, OK 74884 | 2012-01-04 |
1922308030 | Alicia Ann Boatright | Registered Nurse | Us Highway 56 & 270 Junction, Wewoka, OK 74884 | 2010-10-25 |
Find all providers in zip 74884 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
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1699318550 | Community Health Center of Northeast Oklahoma, Inc. | Clinic/Center | 220 S Mickey Mantle Blvd, Commerce, OK 74339-2924 | 2019-10-23 |
1013567940 | Community Health Center of Southeast Kansas, Inc. | Clinic/Center | 7 S 1st St, Wyandotte, OK 74370-2268 | 2019-09-12 |
1013569961 | Community Health Connection, Inc. | Clinic/Center | 13702 E 46th Pl, Tulsa, OK 74134-5919 | 2019-07-11 |
1184286726 | Central Oklahoma Family Medical Center, Inc | Clinic/Center | 302 W Smith Street, Stratford, OK 74872-4648 | 2019-07-03 |
1982263752 | Shortgrass Community Health Center, Inc | Clinic/Center | 211 East Broadway, Altus, OK 73521 | 2019-06-06 |
1265902589 | Community Health Center of Northeast Oklahoma | Clinic/Center | 244 S Scraper Suite D, Vinita, OK 74301-3716 | 2018-11-29 |
1063988673 | Central Oklahoma Family Medical Center, Inc | Clinic/Center | 905 Colony Drive Bldg, Ada, OK 74820 | 2018-10-22 |
1306352547 | Variety Care, Inc. | Clinic/Center | 721 W Britton Rd, Oklahoma City, OK 73114-2909 | 2017-12-26 |
1568976991 | Arkansas Verdigris Valley Health Centers,inc. | Clinic/Center | 201 North 32nd Street, Muskogee, OK 74401-2104 | 2017-11-21 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.