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General NPI Number Information
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NPI Number | 1467560250
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Entity Type | Organization
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Legal Business Name | CLINICAL CARE CONSULTANTS, INC
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 130 S MAIN ST
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City | OWASSO
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State | OK
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Zip | 74055-3108
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Country | US
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Telephone | 918-274-9111
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Fax | 918-274-1745
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Provider Business Mailing Address
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Address Line | P.O. BOX 1204
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City | OWASSO
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State | OK
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Zip | 74055-5815
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Country | US
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Telephone | 918-274-9111
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Fax | 918-274-1745
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | MRS. KATHY MAY CAMPBELL
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Credential | PHARM.D.
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Telephone | 918-274-9111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 11371
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License Number State | OK
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