Provider Demographics
NPI:1710510995
Name:ANVIL RESOURCES CORPORATION
Entity Type:Organization
Organization Name:ANVIL RESOURCES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-724-2010
Mailing Address - Street 1:2126 S MERIDIAN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73108-1724
Mailing Address - Country:US
Mailing Address - Phone:405-724-2010
Mailing Address - Fax:405-724-2001
Practice Address - Street 1:2126 S MERIDIAN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73108-1724
Practice Address - Country:US
Practice Address - Phone:405-724-2010
Practice Address - Fax:405-724-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-17
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine