MEDICARE: GERIATRIC ADVANCED PREVENTIVE SERVICES

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	261QF0050X	Non-Surgical Family Planning Clinic/Center

General Provider Information

NPI Number	:	1881319325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GERIATRIC ADVANCED PREVENTIVE SERVICES

Provider Business Mailing Address
First Line	:	8551 N 125TH EAST AVE STE 250
Second Line	:
City	:	OWASSO
State	:	OK
Zip	:	74055-2160
Country	:	US
Telephone Number	:	855-505-4277
Fax Number	:

Provider Business Practice Location Address
First Line	:	8551 N 125TH EAST AVE STE 250
Second Line	:
City	:	OWASSO
State	:	OK
Zip	:	74055-2160
Country	:	US
Telephone Number	:	855-505-4277
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	JOSEPH CAZZELL
Credential	:
Telephone Number	:	855-505-4277

Provider Enumeration Date	:	10/06/2022
Last Update Date	:	10/06/2022

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