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General NPI Number Information
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NPI Number | 1669129516
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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 | 03/09/2022
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 6000 QUALITY WAY
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City | PRINCE GEORGE
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State | VA
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Zip | 23875-3038
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Country | US
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Telephone | 800-993-8244
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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 | DIRECTOR, PRODUCT & DATA MANAGEMENT
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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