Provider Demographics
NPI:1104372390
Name:ADAIR COUNTY ENVIRONMENT HEALTH INITIATIVE
Entity Type:Organization
Organization Name:ADAIR COUNTY ENVIRONMENT HEALTH INITIATIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HEMBREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-696-2132
Mailing Address - Street 1:10 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:STILWELL
Mailing Address - State:OK
Mailing Address - Zip Code:74960-3004
Mailing Address - Country:US
Mailing Address - Phone:918-696-2132
Mailing Address - Fax:
Practice Address - Street 1:10 N 2ND ST
Practice Address - Street 2:
Practice Address - City:STILWELL
Practice Address - State:OK
Practice Address - Zip Code:74960-3004
Practice Address - Country:US
Practice Address - Phone:918-696-2132
Practice Address - Fax:918-696-1138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-29
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory