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General NPI Number Information
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NPI Number | 1407030356
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Entity Type | Organization
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Legal Business Name | ANGELS HEALTH CARE CLINIC INC
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 12/27/2007
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Provider Practice Location Address
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Address Line | 47922 ST HWY 99
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City | PAWHUSKA
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State | OK
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Zip | 74056
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Country | US
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Telephone | 918-349-2290
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Fax | 918-349-2290
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Provider Business Mailing Address
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Address Line | 47922 ST HWY 99
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City | PAWHUSKA
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State | OK
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Zip | 74056
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Country | US
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Telephone | 918-349-2290
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Fax | 918-349-2290
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Authorized Official
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Title or Position | DIRECTOR
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Name | THERESA A FLOWERETTE
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Credential |
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Telephone | 918-349-4729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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