| Family Health Center Of Southern Oklahoma, Inc | |
|
1504 S Virginia Ave Atoka OK 74525-3246 | |
| (580) 889-4746 | |
| (580) 889-4735 |
| Full Name | Family Health Center Of Southern Oklahoma, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1504 S Virginia Ave, Atoka, Oklahoma |
| Authorized Official Name and Position | Tina J Davis (CEO) |
| Authorized Official Contact | 5803712343 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Health Center Of Southern Oklahoma, Inc 610 E 24th St Tishomingo OK 73460-3245 Ph: (580) 371-2343 | Family Health Center Of Southern Oklahoma, Inc 1504 S Virginia Ave Atoka OK 74525-3246 Ph: (580) 889-4746 |
| NPI Number | 1659797314 |
|---|---|
| Provider Enumeration Date | 03/05/2014 |
| Last Update Date | 07/01/2014 |
| Medicare PECOS PAC ID | 4284537457 |
|---|---|
| Medicare Enrollment ID | O20140731000315 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659797314 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Oklahoma) | Primary |
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