Provider Demographics
NPI:1659892115
Name:HENRI BIENVENIDO RAMIREZ MENDEZ
Entity Type:Organization
Organization Name:HENRI BIENVENIDO RAMIREZ MENDEZ
Other - Org Name:BEEWELL FAMILY HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HENRI
Authorized Official - Middle Name:BIENVENIDO
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-235-2047
Mailing Address - Street 1:107 REDBUD LN
Mailing Address - Street 2:
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953-2041
Mailing Address - Country:US
Mailing Address - Phone:918-208-7487
Mailing Address - Fax:918-208-7687
Practice Address - Street 1:500 S BROADWAY ST STE B
Practice Address - Street 2:
Practice Address - City:POTEAU
Practice Address - State:OK
Practice Address - Zip Code:74953-3819
Practice Address - Country:US
Practice Address - Phone:918-208-7497
Practice Address - Fax:918-208-7687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-05
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care