MEDICARE: CAREATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1396396891
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREATC

Provider Business Mailing Address
First Line	:	4500 S 129TH EAST AVE STE 191
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74134-5891
Country	:	US
Telephone Number	:	918-779-7458
Fax Number	:

Provider Business Practice Location Address
First Line	:	820 QUIK TRIP WAY
Second Line	:
City	:	BELTON
State	:	MO
Zip	:	64012-4658
Country	:	US
Telephone Number	:	800-993-8244
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	SPENCER D LLOYD
Credential	:
Telephone Number	:	918-779-7458

Provider Enumeration Date	:	09/25/2019
Last Update Date	:	09/25/2019

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Directions to “CAREATC ” Practice Location

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