UTICA PARK CLINIC PRIMARY CARE – NPI #1295232478
Clinic/Center

UTICA PARK CLINIC PRIMARY CARE is an AHC clinic located in HENRYETTA, OK. NPPES has assigned the NPI number 1295232478 to UTICA PARK CLINIC PRIMARY CARE on April 12, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “UTICA PARK CLINIC PRIMARY CARE” is a dba name, the actual legal business name for this organization is AHS HENRYETTA HOSPITAL LLC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QR1300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Rural Health

The NPI profile was previously updated about 7 years ago on May 29, 2019. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for UTICA PARK CLINIC PRIMARY CARE below.

NPI Profile for
AHS HENRYETTA HOSPITAL LLC

NPI Number
1295232478
Enumeration Date

(more than 8 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
AHS HENRYETTA HOSPITAL LLC
Doing Business As (dba): UTICA PARK CLINIC PRIMARY CARE
Primary location
2405 W MAIN ST STE A
HENRYETTA, OK 74437
Phone: (918) 650-1180 Fax: (918) 650-1294
Mailing address
2405 W MAIN ST
HENRYETTA, OK 74437-3893
Phone: (918) 650-1180 Fax: (918) 650-1294
Organization Subpart
Yes - UTICA PARK CLINIC PRIMARY CARE is subpart of another organization.
Authorized Official
STEPHEN PETROVICH
EVP
Phone: (615) 296-3000
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QR1300X
- Clinic/Center / Rural Health (Primary)
261Q00000X
- Clinic/Center

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.