Provider Demographics
NPI:1063057461
Name:HEALTH CARE DIRECT, LLC
Entity type:Organization
Organization Name:HEALTH CARE DIRECT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWNFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:580-821-2430
Mailing Address - Street 1:PO BOX 273
Mailing Address - Street 2:
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73648-0273
Mailing Address - Country:US
Mailing Address - Phone:580-821-2430
Mailing Address - Fax:
Practice Address - Street 1:920 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-2829
Practice Address - Country:US
Practice Address - Phone:580-821-2430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-10
Last Update Date:2019-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service