| Organization Name: | NRA ADA OKLAHOMA LLC |
| NPI Number: | 1083651806 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK R FAWCETT (TREASURER) |
| Mailing Address: | 324 Nw J.a. Richardson Loop Ada |
| State: | OK US |
| Postal Code: | 748202017 |
| Phone Number: | 5804219131 |
| Fax Number: | 5804219135 |
| NPI Enumeration Date: | 06/01/2006 |
| NPI Last Update Date: | 06/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0700X |
| License Number: | N/A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
| Taxonomy Definition: | |