Provider Demographics
NPI:1134772981
Name:ADAIR COUNTY HEALTH CENTER, INC
Entity type:Organization
Organization Name:ADAIR COUNTY HEALTH CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-696-3101
Mailing Address - Street 1:PO BOX 272
Mailing Address - Street 2:
Mailing Address - City:STILWELL
Mailing Address - State:OK
Mailing Address - Zip Code:74960-0272
Mailing Address - Country:US
Mailing Address - Phone:918-696-3101
Mailing Address - Fax:918-696-3388
Practice Address - Street 1:1401 W LOCUST ST
Practice Address - Street 2:
Practice Address - City:STILWELL
Practice Address - State:OK
Practice Address - Zip Code:74960-3275
Practice Address - Country:US
Practice Address - Phone:918-696-3101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADAIR COUNTY HEALTH CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health