Healthcare Provider Details

I. General information

NPI: 1699030528
Provider Name (Legal Business Name): COMMUNITY HEALTH CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2012
Last Update Date: 03/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E. SANTA FE
CARNEY OK
74832
US

IV. Provider business mailing address

PO BOX 30589
OKLAHOMA CITY OK
73140
US

V. Phone/Fax

Practice location:
  • Phone: 405-865-2020
  • Fax: 405-769-9685
Mailing address:
  • Phone: 405-769-3301
  • Fax: 405-769-9685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: ISABELLA LAWSON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MBA
Phone: 405-769-3301