Organization
CENTRAL OK FAMILY MED CTR
Active
Other names
COFMC Konawa
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENISE SHARP ARNP (INTERIM CE.O.)
(580) 925-3286
Entity
Organization
Contact information
Practice address
527 W 3RD ST, KONAWA, OK 74849
(580) 925-3286
(580) 925-2362
Mailing address
PO BOX 358, 527 W 3RD ST, KONAWA, OK 74849
(580) 925-3286
(580) 925-2362
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100737160D
—
OK
Enumeration date
05/11/2007
Last updated
10/04/2010
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