Organization
COMMUNITY HEALTH CENTER OF NORTHEAST OKLAHOMA
Active
Parent organization
H80CS26585
Other names
Welch Community Health Center, Route 66 Health Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
H80CS26585
Authorized official
MR. PATRICK MICHAEL PEER MHA (CHIEF EXECUTIVE OFFICER)
(918) 257-8029
Entity
Organization
Contact information
Practice address
343 S. COMMERCIAL STREET, WELCH, OK 74369
(918) 257-8029
(918) 257-8042
Mailing address
PO BOX 705, AFTON, OK 74331-0705
(918) 257-8029
(918) 257-8042
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200539480A
—
OK
Enumeration date
09/15/2017
Last updated
06/16/2018
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