Provider Demographics
NPI:1568649887
Name:AFFORDABLE AFTER HOURS HEALTHCARE
Entity Type:Organization
Organization Name:AFFORDABLE AFTER HOURS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:SCANTLING
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:918-653-2345
Mailing Address - Street 1:714 HIGHWAY 59 N
Mailing Address - Street 2:
Mailing Address - City:HEAVENER
Mailing Address - State:OK
Mailing Address - Zip Code:74937-2252
Mailing Address - Country:US
Mailing Address - Phone:918-653-2345
Mailing Address - Fax:918-653-2385
Practice Address - Street 1:714 HIGHWAY 59 N
Practice Address - Street 2:
Practice Address - City:HEAVENER
Practice Address - State:OK
Practice Address - Zip Code:74937-2252
Practice Address - Country:US
Practice Address - Phone:918-653-2345
Practice Address - Fax:918-653-2385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKROO46658261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200120850AMedicaid