| Organization Name: | IMMEDIATE CARE OF OKLAHOMA L.L.C. |
| NPI Number: | 1578932299 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KEVIN PENWELL (COM, PRESIDENT) |
| Mailing Address: | 5700 Se 74th St Okc |
| State: | OK US |
| Postal Code: | 731351106 |
| Phone Number: | 4056006869 |
| Fax Number: | 4056006978 |
| NPI Enumeration Date: | 09/23/2015 |
| NPI Last Update Date: | 10/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | 4106 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |