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General NPI Number Information
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NPI Number | 1144041666
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Entity Type | Organization
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Legal Business Name | CAREATC
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 1507 BROOMTOWN RD
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City | LA FAYETTE
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State | GA
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Zip | 30728-3407
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Country | US
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Telephone | 706-638-3559
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Fax |
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Provider Business Mailing Address
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Address Line | 4500 S 129TH EAST AVE STE 191
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City | TULSA
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State | OK
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Zip | 74134-5891
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SR. DIRECTOR, DATA AND ANALYTICS
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Name | KELLY BENDER
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Credential |
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Telephone | 918-779-7475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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