Provider Demographics
NPI:1427245646
Name:FAMILY CARE OF WOODWARD LLC
Entity type:Organization
Organization Name:FAMILY CARE OF WOODWARD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEMANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:580-256-2900
Mailing Address - Street 1:1611 MAIN ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-3021
Mailing Address - Country:US
Mailing Address - Phone:580-256-2900
Mailing Address - Fax:
Practice Address - Street 1:1611 MAIN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-3021
Practice Address - Country:US
Practice Address - Phone:580-256-2900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty