Practice Information |
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Organization Legal Name
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MIDWEST NEPHROLOGY GROUP PLLC
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Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
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Group Practice PAC ID
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7214210624
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Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
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Number of Group Practice members
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5
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Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
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Line 1 Street Address
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9230 E RENO AVE
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Group Practice or individual's line 1 address
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Line 2 Street Address
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SUITE B
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Group Practice or individual's line 2 address
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City
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MIDWEST CITY
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Group Practice or individual's city
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State
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OK
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Group Practice or individual's state
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Zip Code
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731303320
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Group Practice or individual's zip code (9 digits when available)
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Phone Number
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4057374900
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Phone number is listed only when there is a single phone number available for the practice location address
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Hospital(s) Affiliation Information |
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Hospital Affiliation CCN 1
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370094
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Medicare CCN of hospital where individual professional provides service 1
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Hospital Affiliation LBN 1
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ALLIANCEHEALTH MIDWEST
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Legal business name of hospital where individual professional provides service 1
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Hospital Affiliation CCN 2
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370028
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Medicare CCN of hospital where individual professional provides service 2
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Hospital Affiliation LBN 2
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INTEGRIS BAPTIST MEDICAL CENTER, INC
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Legal business name of hospital where individual professional provides service 2
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Hospital Affiliation CCN 3
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370234
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Medicare CCN of hospital where individual professional provides service 3
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Hospital Affiliation LBN 3
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OKLAHOMA HEART HOSPITAL SOUTH, LLC
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Legal business name of hospital where individual professional provides service 3
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Hospital Affiliation CCN 4
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370215
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Medicare CCN of hospital where individual professional provides service 4
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Hospital Affiliation LBN 4
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OKLAHOMA HEART HOSPITAL, LLC
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Legal business name of hospital where individual professional provides service 4
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Hospital Affiliation CCN 5
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370149
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Medicare CCN of hospital where individual professional provides service 5
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Hospital Affiliation LBN 5
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ST ANTHONY SHAWNEE HOSPITAL
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Legal business name of hospital where individual professional provides service 5
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Professional Accepts Medicare Assignment
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Y
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