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General NPI Number Information
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NPI Number | 1568976991
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Entity Type | Organization
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Legal Business Name | ARKANSAS VERDIGRIS VALLEY HEALTH CENTERS,INC.
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Dates
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Enumeration Date | 11/21/2017
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 201 NORTH 32ND STREET
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City | MUSKOGEE
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State | OK
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Zip | 74401-2104
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Country | US
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Telephone | 918-912-2333
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 334
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City | PORTER
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State | OK
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Zip | 74454-0334
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Country | US
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Telephone | 918-483-0111
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Fax |
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Authorized Official
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Title or Position | FINANCE MANAGER
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Name | MR. LIZ BREWER
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Credential |
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Telephone | 918-483-0111
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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 | OK
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | OK
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