PHYSICIANS CHOICE DIALYSIS OF MIDWEST CITY LLC (NPI# 1639776222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639776222 |
| Entity Type | Organization |
| Organization Name | PHYSICIANS CHOICE DIALYSIS OF MIDWEST CITY LLC |
| Practice Address |
3200 Se 29th Street Del City OK 73115 |
| Mailing Address |
211 Commerce Ct Ste 104 Pottstown PA 19464-3483 |
| Practice Telephone | 6104958900 |
| Mailing Telephone | 3022907408 |
| Mailing Fax Number | 6104958652 |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2020-10-06 |
| Authorized Official Name | KELLY SMITH (DIRECTOR, CONTRACTS) |
| Authorized Official Telephone | 3022907408 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2472R0900X |
Technician, Other Specialization: Renal Dialysis |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
3200 SE 29TH STREET |
| City | DEL CITY |
| State | OK |
| Zip Code | 73115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942784715 | Iacc/ehi Nw, LLC | General Acute Care Hospital | 4801 S.e. 15th Street, Del City, OK 73115 | 2018-09-18 |
| 1285164392 | Jerry Medlock | Peer Specialist | 4312 Vfw Dr. Apt # 7, 4312 Vfw Dr. Apt # 7, Del City, OK 73115 | 2017-06-13 |
| 1326425588 | Peace of Mind Pediatrics Pllc | Clinic/Center | 5476 Main Street, 104, Del City, OK 73115 | 2015-04-27 |
| 1588077044 | Latasha Aujena Walker | Case Management | 4337 Se15th, Del City, OK 73115 | 2014-06-03 |
| 1164834701 | Affordable Dentures-midwest City, P.C. | Dentist | 5301 Main Street, Suite 111, Del City, OK 73115 | 2014-06-02 |
| 1629488028 | Nikke Sogunro | Counselor | 3517 Ridglea Ct., Del City, OK 73115 | 2014-05-07 |
| 1033539358 | Shelli Holtsman | Counselor | 4329 Se 40th Street, Del City, OK 73115 | 2014-04-25 |
| 1215238514 | Tonya Dailwayne Wilson | Counselor | 4016 S.e. 24th Street, Del City, OK 73115 | 2010-11-03 |
| 1851611099 | Kelly Camille Kingsley | Behavioral Analyst | 4018 Se 11th Street, Del City, OK 73115 | 2010-06-10 |
| 1275852568 | Tanya Skelly | Counselor | 900 Nw 10th Street, Oklahoma City, OK 73115 | 2010-05-26 |
| Find all providers in zip 73115 | ||||
| Taxonomy Code | 2472R0900X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Technician, Other |
| Specialization | Renal Dialysis |
| Definition to come... |
Please comment or provide details below to improve the information on PHYSICIANS CHOICE DIALYSIS OF MIDWEST CITY LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.