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General NPI Number Information
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NPI Number | 1093184145
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Entity Type | Organization
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Legal Business Name | EAST CENTRAL OKLAHOMA FAMILY HEALTH CENTER, INC.
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Dates
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Enumeration Date | 09/18/2015
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 207 W 1ST ST
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City | WEWOKA
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State | OK
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Zip | 74884-2103
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Country | US
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Telephone | 52-575-4224
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Fax | 405-257-5463
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Provider Business Mailing Address
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Address Line | P.O. BOX 236
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City | WETUMKA
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State | OK
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Zip | 74883-0236
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Country | US
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Telephone | 405-452-3151
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Fax | 405-452-3310
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Authorized Official
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Title or Position | CEO
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Name | MRS. DONNA SUE DYER
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Credential | MSHR
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Telephone | 405-452-3151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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