Organization
AMBEST FAMILY HEALTH CLINICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OKEY ILOEGBUNAM NP (OWNER / MEMBER MANAGER)
(770) 688-6691
Entity
Organization
Contact information
Practice address
4841 S MESA VILLAS DR APT 3, FORT MOHAVE, AZ 86426-6436
(928) 577-7368
(928) 299-3373
Mailing address
4325 S OTIS RD, FORT MOHAVE, AZ 86426-6385
(770) 688-6691
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
576901
—
AZ
01
—
P22410618
CORPORATION ID
AZ
Enumeration date
08/16/2019
Last updated
03/13/2020
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