| Great Salt Plains Health Center, Inc. | |
|
2615 E Randolph Ave Enid OK 73701-4670 | |
| (580) 596-2800 | |
| Not Available |
| Full Name | Great Salt Plains Health Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2615 E Randolph Ave, Enid, Oklahoma |
| Authorized Official Name and Position | Timothy Starkey (CEO) |
| Authorized Official Contact | 5802151766 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Salt Plains Health Center, Inc. 205 W Maple Ave Ste 1000 Enid OK 73701-4047 Ph: (580) 233-2900 | Great Salt Plains Health Center, Inc. 2615 E Randolph Ave Enid OK 73701-4670 Ph: (580) 596-2800 |
| NPI Number | 1962245811 |
|---|---|
| Provider Enumeration Date | 06/18/2024 |
| Last Update Date | 06/18/2024 |
| Medicare PECOS PAC ID | 9133201171 |
|---|---|
| Medicare Enrollment ID | O20240701002382 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962245811 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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