Organization
KIAMICHI FAMILY MEDICAL CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY GILBREATH (CEO)
(580) 241-5294
Entity
Organization
Contact information
Practice address
2809 NE LINCOLN RD, IDABEL, OK 74745-2421
(580) 286-6688
(580) 286-6699
Mailing address
601 SE WASHINGTON ST, IDABEL, OK 74745-3319
(580) 286-6688
(580) 286-6699
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200003420C
—
OK
Enumeration date
08/05/2006
Last updated
05/05/2025
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