Organization
VARIETY CARE, INC
Active
Parent organization
VARIETY CARE, INC
Other names
Variety Care Fort Cobb
Organization subpart
Yes
Provider details
NPI number
Legal business name
VARIETY CARE, INC
Authorized official
TIM REDDOUT (CFO)
(405) 632-6688
Entity
Organization
Contact information
Practice address
111 W MAIN ST, FORT COBB, OK 73038-5866
(405) 632-6688
(405) 643-9296
Mailing address
3000 N GRAND BLVD, OKLAHOMA CITY, OK 73107-1818
(405) 632-6688
(844) 689-9671
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100734110I
—
OK
01
—
CIGNA DENTAL
263715
OK
Enumeration date
08/16/2006
Last updated
02/26/2020
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