# RURAL WELLNESS FAIRFAX INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rural Wellness Fairfax Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790314466
- **Authorized official:** ELIZABETH J PUSEY (PRESIDENT)
- **Authorized official phone:** (949) 645-2321

## Contact information

- **Practice address:** 40 HOSPITAL RD, FAIRFAX, OK 74637-5084
- **Practice address phone:** (918) 642-8827
- **Practice address fax:** (918) 642-3298
- **Mailing address:** 2524 N BROADWAY, EDMOND, OK 73034-4172
- **Mailing address phone:** (949) 322-4337

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/05/2020
- **Last updated:** 10/21/2024