Healthcare Provider Details

I. General information

NPI: 1316109952
Provider Name (Legal Business Name): COMMUNITY HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 07/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3077 E COLLEGE AVE
GUTHRIE OK
73044-8065
US

IV. Provider business mailing address

PO BOX 640
BELLEVILLE NJ
07109-0640
US

V. Phone/Fax

Practice location:
  • Phone: 405-282-3898
  • Fax: 405-260-0429
Mailing address:
  • Phone: 973-751-7515
  • Fax: 973-751-1394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR0084764
License Number StateOK

VIII. Authorized Official

Name: MRS. MARGARET A LORIMOR
Title or Position: OWNER
Credential: FNP-C
Phone: 405-282-3898