GOOD SHEPHERD COMMUNITY CLINIC, INC; NPI #1730539487

Contact Information

GOOD SHEPHERD COMMUNITY CLINIC, INC

20 12TH AVE NW
ARDMORE, OK 73401-5722

Phone: 580-223-3411
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Clinic Pharmacy	3336C0002X	58	Medical Supply Company with Pharmacist

Indicates primary specialty

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NPI Profile & details for GOOD SHEPHERD COMMUNITY CLINIC, INC

NPI # 1730539487

LBN Legal business name GOOD SHEPHERD COMMUNITY CLINIC, INC

Authorized official TERESA MYERS - (EXECUTIVE DIRECTOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 06/14/2016

Last updated 03/07/2023 - About 3 years ago

Identifiers

	Other	3729514	NCPDP
OK	Other	12-8483	OKLAHOMA STATE BOARD OF 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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