Organization Name: | SOUTH CENTRAL MEDICAL AND RESOURCE CENTER INC. |
NPI Number: | 1366585564 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICKLIN JOE PACK (CEO) |
Mailing Address: | 216 S Main St Lindsay |
State: | OK US |
Postal Code: | 730525634 |
Phone Number: | 4057561414 |
Fax Number: | 4057561162 |
NPI Enumeration Date: | 02/15/2007 |
NPI Last Update Date: | 10/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |