Green Country Medical, Inc.
Organization Active NPI Clinical Medical Laboratory · Nowata, OK
NPI 1487871570 · NPPES record last updated Oct 30, 2007
Key facts
- NPI
- 1487871570
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- Legal business name
- GREEN COUNTRY MEDICAL, INC.
- Practice address
- 712 E Osage Ave
Nowata, OK 74048-3638 - Phone
- (918) 273-0140
- NPI assigned
- Apr 19, 2007
- Organization subpart
- No
Authorized official
- Name
- Sheryl Neely
- Title
- RN
- Phone
- (918) 273-0140
Corporate family (same tax ID) 6
Practitioners 1
-
David S Caughell, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 37D0473285 | Green Country Medical, Inc | Provider-performed microscopy | Apr 14, 2028 |
National Provider Directory
- Tax ID family
- Green Country Medical Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Yes |
Addresses
Primary practice location
712 E Osage Ave
Nowata, OK 74048-3638
Mailing address
712 E Osage Ave
Nowata, OK 74048-3638
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- Green Country Medical, Inc
- Green Country Medical, Inc.
- Green Country Medical, Inc.
- Timothy Green
- Sandy Lea Hadley
- Victoria Noel Hallagin
All providers in Nowata, OK · Clinical Medical Laboratory in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.