# TRIAD COMPLETE HEALTHCARE A10 LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Triad Complete Healthcare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528749041
- **Authorized official:** ERIC WINEGARDNER (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (405) 613-9720

## Contact information

- **Practice address:** 4151 N HARRISON, SHAWNEE, OK 74804
- **Practice address phone:** (405) 613-9720
- **Mailing address:** 20228 RED OAK CT, TECUMSEH, OK 74873-7131
- **Mailing address phone:** (405) 613-9720

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/27/2023
- **Last updated:** 02/05/2024