Provider Demographics
NPI:1669480125
Name:CHERYL K BEGLEY
Entity Type:Organization
Organization Name:CHERYL K BEGLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:K
Authorized Official - Last Name:BEGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-889-3287
Mailing Address - Street 1:PO BOX 303
Mailing Address - Street 2:
Mailing Address - City:WAPANUCKA
Mailing Address - State:OK
Mailing Address - Zip Code:73461
Mailing Address - Country:US
Mailing Address - Phone:580-889-3287
Mailing Address - Fax:580-889-4851
Practice Address - Street 1:795 E BLACKJACK RD
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:OK
Practice Address - Zip Code:74525
Practice Address - Country:US
Practice Address - Phone:580-889-3287
Practice Address - Fax:580-889-4851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK4447350001Medicare NSC
OK4447350001Medicare ID - Type Unspecified