| Cah Acquisition Company 12 Llc | |
|
40 Hospital Rd Fairfax OK 74637 | |
| (918) 642-8827 | |
| (918) 642-3298 |
| Full Name | Cah Acquisition Company 12 Llc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 40 Hospital Rd, Fairfax, Oklahoma |
| Authorized Official Name and Position | Tina J Steele (CEO) |
| Authorized Official Contact | 9186423291 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cah Acquisition Company 12 Llc 40 Hospital Rd Fairfax OK 74637-5084 Ph: (918) 642-3291 | Cah Acquisition Company 12 Llc 40 Hospital Rd Fairfax OK 74637 Ph: (918) 642-8827 |
| NPI Number | 1306145339 |
|---|---|
| Provider Enumeration Date | 03/16/2011 |
| Last Update Date | 07/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306145339 | NPI | - | NPPES |
| 200311270C | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 2274 (Oklahoma) | Primary |
Fairfax Medical Facilities Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 212 N Main St, Fairfax, OK 74637 Phone: 918-642-3100 Fax: 918-642-5639 | |
Rural Wellness Fairfax Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 40 Hospital Rd, Fairfax, OK 74637 Phone: 918-642-8827 Fax: 918-642-3298 |