Provider Demographics
NPI:1356070916
Name:COMMUNITY PUBLIC HEALTH, LLC
Entity Type:Organization
Organization Name:COMMUNITY PUBLIC HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KARLYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-402-6811
Mailing Address - Street 1:3750 W MAIN ST STE AA
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-4645
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3750 W MAIN ST STE AA
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-4645
Practice Address - Country:US
Practice Address - Phone:405-653-0641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health