Provider Demographics
NPI:1245432350
Name:COVINGTON HEALTH CLINIC INCORPORATED
Entity Type:Organization
Organization Name:COVINGTON HEALTH CLINIC INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCFADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, ARNP
Authorized Official - Phone:580-402-0543
Mailing Address - Street 1:PO BOX 93
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:OK
Mailing Address - Zip Code:73730-0093
Mailing Address - Country:US
Mailing Address - Phone:580-402-0543
Mailing Address - Fax:580-233-7680
Practice Address - Street 1:402 NORTH FIFTH STREET
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:OK
Practice Address - Zip Code:73730-0093
Practice Address - Country:US
Practice Address - Phone:580-402-0543
Practice Address - Fax:580-233-7680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care