Provider Demographics
NPI:1295465136
Name:REMEDY HEALTH DIRECT PRIMARY CARE
Entity Type:Organization
Organization Name:REMEDY HEALTH DIRECT PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIETZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-CNP
Authorized Official - Phone:918-937-7705
Mailing Address - Street 1:601 E CARL ALBERT PKWY
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-5113
Mailing Address - Country:US
Mailing Address - Phone:918-233-6522
Mailing Address - Fax:918-238-6279
Practice Address - Street 1:601 E CARL ALBERT PKWY
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5113
Practice Address - Country:US
Practice Address - Phone:918-233-6522
Practice Address - Fax:918-238-6279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty