Organization
CAH ACQUISITION COMPANY 9 LLC
Active
Other names
Vici Community Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY R PARKER (CEO)
(580) 922-7361
Entity
Organization
Contact information
Practice address
104 W. BROADWAY, VICI, OK 73859-5900
(580) 995-3004
(580) 995-3006
Mailing address
PO BOX 720, SEILING, OK 73663-0720
(580) 922-7361
(580) 922-7718
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200287200C
—
OK
Enumeration date
03/29/2012
Last updated
10/28/2013
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