# ICARE PRIMARY & WELLNESS CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922671551
- **Authorized official:** KAMI SCRUGGS (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (405) 658-8904

## Contact information

- **Practice address:** 4823 S WESTERN AVE, OKLAHOMA CITY, OK 73109-3835
- **Practice address phone:** (405) 673-4045
- **Mailing address:** 1145 W I 240 SERVICE RD \# BDLF10, OKLAHOMA CITY, OK 73139-2171
- **Mailing address phone:** (405) 658-8904

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/21/2021
- **Last updated:** 07/21/2021