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Contact Information

GOOD SHEPHERD COMMUNITY CLINIC, INC.
1104 WALNUT DR W
ARDMORE, OK73401
 Phone: 580-226-0543
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinic Pharmacy

3336C0002X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for GOOD SHEPHERD COMMUNITY CLINIC, INC.

NPI Number 1316529803
LBN Legal business name GOOD SHEPHERD COMMUNITY CLINIC, INC.
Authorized official TERESA MYERS - (CEO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 04/23/2021
Last updated 04/23/2021 - About 5 years ago
Identifiers
OK Other 12-8917 PHARMACY LICENSE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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