1356351027 NPI number — PLANNED PARENTHOOD OF ARKANSAS AND EASTERN OKLAHOMA PEDIATRICS

Table of content: (NPI 1356351027)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356351027 NPI number — PLANNED PARENTHOOD OF ARKANSAS AND EASTERN OKLAHOMA PEDIATRICS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLANNED PARENTHOOD OF ARKANSAS AND EASTERN OKLAHOMA PEDIATRICS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356351027
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4401 W 109TH ST STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OVERLAND PARK
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66211-1303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
855-841-7526
Provider Business Mailing Address Fax Number:
918-587-1101

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 E PINE ST STE 5
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74106-4855
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-587-1101
Provider Business Practice Location Address Fax Number:
918-592-7610
Provider Enumeration Date:
08/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PARKS
Authorized Official First Name:
VICTORIA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR HEALTH SERVICES OP
Authorized Official Telephone Number:
918-587-4621

Provider Taxonomy Codes

  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100728930F , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com