Provider Demographics
NPI:1346528718
Name:HIV RESOURCE CONSORTIUM, INC.
Entity Type:Organization
Organization Name:HIV RESOURCE CONSORTIUM, INC.
Other - Org Name:TULSA C.A.R.E.S.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-834-4194
Mailing Address - Street 1:3507 E ADMIRAL PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74115-8211
Mailing Address - Country:US
Mailing Address - Phone:918-834-4194
Mailing Address - Fax:918-834-4189
Practice Address - Street 1:3712 E 11TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74112-3952
Practice Address - Country:US
Practice Address - Phone:918-834-4194
Practice Address - Fax:918-834-4189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-02
Last Update Date:2022-04-05
Deactivation Date:2019-10-18
Deactivation Code:
Reactivation Date:2019-10-23
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty