MEDICARE: ARRRC, 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
1	208D00000X	General Practice Physician	3899	OK
2	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1669726188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARRRC, INC.

Provider Business Mailing Address
First Line	:	2149 S.W. 59TH ST.,
Second Line	:	SUITE 105
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73119-7003
Country	:	US
Telephone Number	:	405-548-5224
Fax Number	:	405-548-5285

Provider Business Practice Location Address
First Line	:	2149 S.W. 59TH ST.,
Second Line	:	SUITE 105
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73119-7003
Country	:	US
Telephone Number	:	405-548-5224
Fax Number	:	405-548-5285

Authorized Official
Title or Position	:	ADMINISTRATIVE DIRECTOR
Name	:	MRS. ROSE ANNA MOORE
Credential	:
Telephone Number	:	405-548-5224

Provider Enumeration Date	:	11/06/2012
Last Update Date	:	05/03/2013

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