Organization
NORTHEASTERN OKLAHOMA COMMUNITY HEALTH CENTERS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT ROSENTHAL (CEO)
(918) 772-3390
Entity
Organization
Contact information
Practice address
1310 E BOONE ST, TAHLEQUAH, OK 74464-3338
(918) 456-7700
(918) 458-9314
Mailing address
PO BOX 751, HULBERT, OK 74441-0751
(918) 772-3390
(918) 772-3638
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200057760A
—
OK
Enumeration date
01/25/2006
Last updated
06/09/2020
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