| NPI | 1285224576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA WAYNE FORREST President/CEO 918-805-4885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 251F00000X Home Infusion |
| 253Z00000X In Home Supportive Care | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QR1300X Clinic/Center, Rural Health | |
| 261QS1200X Clinic/Center, Sleep Disorder Diagnostic | |
| 261QU0200X Clinic/Center, Urgent Care | |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
| Enumeration Date | 2021-01-21 |
| Last Update Date | 2022-12-12 |