| Kiamichi Family Medical Center, Inc | |
|
510 S Park Dr Broken Bow OK 74728-5330 | |
| (580) 241-5294 | |
| Not Available |
| Full Name | Kiamichi Family Medical Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 510 S Park Dr, Broken Bow, Oklahoma |
| Authorized Official Name and Position | Amy Gilbreath (CEO) |
| Authorized Official Contact | 5802415294 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kiamichi Family Medical Center, Inc 6026 Battiest Pickens Rd Broken Bow OK 74728-5033 Ph: (580) 241-5294 | Kiamichi Family Medical Center, Inc 510 S Park Dr Broken Bow OK 74728-5330 Ph: (580) 241-5294 |
| NPI Number | 1780172916 |
|---|---|
| Provider Enumeration Date | 04/24/2018 |
| Last Update Date | 04/26/2018 |
| Medicare PECOS PAC ID | 7315855541 |
|---|---|
| Medicare Enrollment ID | O20180724001230 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780172916 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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