Chandler Outreach Medical Center, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CHANDLER OUTREACH MEDICAL CENTER, LLC

Practice address

1206 Manvel Ave
Ste C
Chandler, OK 74834-4401

Phone

(405) 258-5252

Fax

(405) 258-5552

NPI assigned

Oct 6, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kristin Sells, P.A.

Title

Director

Phone

(405) 258-5252

Specialties & licenses 1

Addresses

Other names 1

• Chandler Outreach Medical Center Doing business as

Tax ID family

Chandler Outreach Medical Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Chandler Outreach Medical Center

  • Family Medicine Physician
  • Chandler, OK
  • NPI 1568407476
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992892228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 108810",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731018810",
            "telephone_number": "405-608-1200",
            "fax_number": "405-608-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 MANVEL AVE",
            "address_2": "STE C",
            "city": "CHANDLER",
            "state": "OK",
            "postal_code": "748344401",
            "telephone_number": "405-258-5252",
            "fax_number": "405-258-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANDLER OUTREACH MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SELLS",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "405-258-5252",
        "authorized_official_credential": "P.A."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chandler Outreach Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chandler Clinic a Division of Plaza Medical Group, PC
• Chandler Dental PLLC
• Chandler Nursing and Rehab LLC
• Chandler Outreach Clinic LLC
• Chandler Outreach Medical Center
• Chandler Public Schools
• Chandler Therapy & Living Center LLC
• Christopher Linn Chiles
• City of Chandler
• Ginger Clark

• All providers in Chandler, OK
• Durable Medical Equipment & Medical Supplies in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.