Provider Demographics
NPI:1760933634
Name:MCO HEALTH PLANS, INC
Entity Type:Organization
Organization Name:MCO HEALTH PLANS, INC
Other - Org Name:HEALTH CARE MANAGEMENT COMPANY OF OKLAHOMA, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARDIMON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, BSN, RN
Authorized Official - Phone:828-989-6300
Mailing Address - Street 1:1908 12TH AVE NW
Mailing Address - Street 2:SUITE B
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-1196
Mailing Address - Country:US
Mailing Address - Phone:580-223-8805
Mailing Address - Fax:580-223-8885
Practice Address - Street 1:1908 12TH AVE NW
Practice Address - Street 2:SUITE B
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-1196
Practice Address - Country:US
Practice Address - Phone:580-223-8805
Practice Address - Fax:580-223-8885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontologyGroup - Multi-Specialty