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NPI Code Detail

MEDICARE: GREAT SALT PLAINS HEALTH CENTER, INC.

MEDICARE: GREAT SALT PLAINS HEALTH CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1245667732
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREAT SALT PLAINS HEALTH CENTER, INC.
Provider Business Mailing Address
First Line : 405 S OKLAHOMA AVE
Second Line :
City : CHEROKEE
State : OK
Zip : 73728-2545
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 231 S 30TH ST
Second Line :
City : ENID
State : OK
Zip : 73701-6455
Country : US
Telephone Number : 580-223-2900
Fax Number :
Authorized Official
Title or Position : CEO
Name : TIM STARKEY
Credential :
Telephone Number : 580-596-2800
Provider Enumeration Date : 09/30/2013
Last Update Date : 07/03/2023

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Directions to “GREAT SALT PLAINS HEALTH CENTER, INC. ” Practice Location

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