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General NPI Number Information
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NPI Number | 1376663203
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Entity Type | Organization
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Legal Business Name | NORTHERN OTTAWA COUNTY CO-OP
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 715 WEST A STREET
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City | PICHER
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State | OK
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Zip | 74360
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Country | US
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Telephone | 918-673-1714
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Fax | 918-673-1718
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Provider Business Mailing Address
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Address Line | PO BOX 280
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City | PICHER
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State | OK
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Zip | 74360-0280
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Country | US
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Telephone | 918-673-1714
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Fax | 918-673-1718
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Authorized Official
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Title or Position | SPECIAL ED DIRECTOR-MEDICAID CLERK
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Name | MRS. ANDREA H. BERRY
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Credential |
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Telephone | 918-673-1714
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State | OK
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