| Organization Name: | B3W LLC |
| NPI Number: | 1528351780 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHEILA R. CASSAR (PROVIDER ENROLLMENT COORDINATOR) |
| Mailing Address: | 115 N Mustang Rd Mustang |
| State: | OK US |
| Postal Code: | 730643912 |
| Phone Number: | 4052565595 |
| Fax Number: | 4052655596 |
| NPI Enumeration Date: | 05/20/2011 |
| NPI Last Update Date: | 09/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |