Healthcare Provider Details
I. General information
NPI: 1265198840
Provider Name (Legal Business Name): RURAL WELLNESS ANADARKO INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/09/2021
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1002 E CENTRAL BLVD
ANADARKO OK
73005-4405
US
IV. Provider business mailing address
2524 N BROADWAY
EDMOND OK
73034-4172
US
V. Phone/Fax
- Phone: 405-247-2553
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 275N00000X |
| Taxonomy | Medicare Defined Swing Bed Hospital Unit |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ELIZABETH
PUSEY
Title or Position: PRESIDENT
Credential: MD
Phone: 949-322-4337