| Organization Name: | FAIRFAX MEDICAL FACILITIES INC |
| NPI Number: | 1609040864 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NEAL D MCCONAGHY (BOARD CHAIRMAN) |
| Mailing Address: | 119 W Main St Hominy |
| State: | OK US |
| Postal Code: | 740351031 |
| Phone Number: | 9188854640 |
| Fax Number: | 9188854644 |
| NPI Enumeration Date: | 04/18/2008 |
| NPI Last Update Date: | 05/29/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |