PRAGUE HEALTHCARE AUTHORITY NPI 1881923290

NPI Information

NPI: 1881923290
Provider Name: PRAGUE HEALTHCARE AUTHORITY

Doing Business As: PRAGUE FAMILY CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 37D2004036

Address:
1322 KLABZUBA AVENUE
PRAGUE, OK
ZIP 74864
Phone: (405) 567-4922
Get Directions

PRAGUE HEALTHCARE AUTHORITY is a rural health clinic center in Prague, OK. PRAGUE HEALTHCARE AUTHORITY NPI is 1881923290. The provider is registered as an organization entity type.
The provider Is Doing Business As Prague Family Clinic.

The provider's business location address is:

1322 KLABZUBA AVENUE
PRAGUE, OK
ZIP 74864
Phone: (405) 567-4922
Fax: (405) 567-4290

The provider's authorized official is Dianne M Dyer .
The authorized official title is Revenue Cycle Manager and has the following contact phone number (405) 567-4922.

The CLIA number assigned to this NPI record is 37D2004036 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/14/2009 and was last updated on 3/9/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health	2164	OKLAHOMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	200231400C	MEDICAID	OKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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