Provider Demographics
NPI:1467817940
Name:RODI LLC
Entity Type:Organization
Organization Name:RODI LLC
Other - Org Name:NEIGHBORHOOD WALK-IN MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MELLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, FNP-BC
Authorized Official - Phone:918-852-6057
Mailing Address - Street 1:8316 E 61ST ST STE 101A
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-1908
Mailing Address - Country:US
Mailing Address - Phone:918-893-3535
Mailing Address - Fax:918-893-3570
Practice Address - Street 1:8316 E 61ST ST
Practice Address - Street 2:STE 101 A
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-1910
Practice Address - Country:US
Practice Address - Phone:918-893-3535
Practice Address - Fax:918-893-3570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-28
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200623310AMedicaid