The Family Care Center of Harrah, Inc.
Organization Active NPI Primary Care Clinic/Center · Harrah, OK
NPI 1801840368 · NPPES record last updated Apr 24, 2008
Key facts
- NPI
- 1801840368
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- License
- 2323 (OK)
- Legal business name
- THE FAMILY CARE CENTER OF HARRAH, INC.
- Practice address
- 20826 Main St
Harrah, OK 73045-9755 - Phone
- (405) 454-2404
- Fax
- (405) 454-6372
- NPI assigned
- May 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Len U Lacefield Jr.
- Title
- Administrator
- Phone
- (405) 454-2404
Practitioners 3
-
Cary L Lacefield, D.O.
-
Angela Diane Bartlow, PA-C
-
Sarah Kathryn Walsh, APRN-CNS
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061016000298 | OK | Part B Supplier - Clinic/Group Practice | 6709882715 |
Receives reassigned benefits from 2 practitioners Practice locations: Harrah, OK |
National Provider Directory
Locations
20826 Main St
Harrah, OK 73045
Phone (405) 454-2404
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Primary Care Clinic/Center | 261QP2300X | 2323 | OK | Yes |
Addresses
Primary practice location
20826 Main St
Harrah, OK 73045-9755
Mailing address
PO Box 900
Harrah, OK 73045-0900
Phone (405) 454-2404
Other providers in Harrah, OK
- Alisha Brooke Smith
- Trisha Dawn Stevens
- Cynthia Stober
- Jennifer Swank
- Suzanne Tarver
- The Office of Counseling Services
- Jacob Charles Thomas
- Troy William Tippeconnic
- Natalie Valentine
- Rebecca D Webster
All providers in Harrah, OK · Primary Care Clinic/Center in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.