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General NPI Number Information
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NPI Number | 1871960195
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Entity Type | Organization
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Legal Business Name | COORDINATED CARE HEALTH SOLUTIONS, LLC
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Dates
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Enumeration Date | 08/24/2015
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 10120 BROADWAY EXT STE 220
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City | OKLAHOMA CITY
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State | OK
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Zip | 73114-6300
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Country | US
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Telephone | 405-605-0720
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Fax | 405-463-0120
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Provider Business Mailing Address
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Address Line | PO BOX 108835
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City | OKLAHOMA CITY
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State | OK
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Zip | 73101-8835
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Country | US
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Telephone | 405-605-0720
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Fax | 405-730-8047
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | HUNTER JOE HOGAN III
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Credential | DPH
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Telephone | 405-418-2929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 1871960195
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License Number State | OK
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