Black Oak Clinic Llc

LBN: Black Oak Clinic Llc
Black Oak Clinic Llc is an health care organization with primary practice located at 110 W 1St St , Broken Bow OK 74728. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Black Oak Clinic Llc can be contacted via phone (580) 584-3099, or through Black, Megan Elizabeth via phone (580) 584-3099.

Contact Information

Primary practice address
110 W 1St St Broken Bow OK 74728
Phone: (580) 584-3099
Fax: (580) 584-3097
Website:
Map and Directions
Authorized official contact:
Name: Black, Megan Elizabeth APRN C-NP
Phone: (580) 584-3099

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1366954661
LBN Legal business name Black Oak Clinic Llc
DBA Doing business as
Authorized official Black, Megan Elizabeth APRN C-NP
Entity Organization
Organization subpart 1 No
Enumeration date Oct 26th, 2017
Last updated Aug 7th, 2018 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366954661 NPPES
Oklahoma MEDICAID 200740450A

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