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Organization

GROVES & MINER ENTERPRISES LLC

Active
Parent organization
GROVES ENTERPRISES PLLC
Other names
YourCARE-S. Penn
Organization subpart
Yes

Provider details

NPI number
Legal business name
GROVES ENTERPRISES PLLC
Authorized official
PHILICIA M GROVES APRN (OWNER/NP)
(405) 350-4300
Entity
Organization

Contact information

Practice address
10700 S PENNSYLVANIA AVE, OKLAHOMA CITY, OK 73170
(405) 691-9700
(405) 691-9702
Mailing address
10700 S PENNSYLVANIA AVE, OKLAHOMA CITY, OK 73170-4207
(405) 691-9700
(405) 691-9702

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200529800A
OK
01
360896
MEDICARE PTAN
Enumeration date
04/03/2014
Last updated
04/24/2015
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