Provider Demographics
NPI:1306033758
Name:HEALTHY HEARTBEAT, PC
Entity Type:Organization
Organization Name:HEALTHY HEARTBEAT, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAVEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RIHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:405-231-8882
Mailing Address - Street 1:1226 N SHARTEL AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-2421
Mailing Address - Country:US
Mailing Address - Phone:405-231-8882
Mailing Address - Fax:405-231-8884
Practice Address - Street 1:1226 N SHARTEL AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-2421
Practice Address - Country:US
Practice Address - Phone:405-231-8882
Practice Address - Fax:405-231-8884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19336174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100746250AMedicaid
OK100746250AMedicaid