PWWL CENTERS LLC NPI 1154198737

NPI Information

  • NPI: 1154198737
  • Provider Name: PWWL CENTERS, LLC
  • Classification: Clinic/Center - 261QC1500X
  • Specialization: Community Health
  • Entity Type: Organization
  • Address: 644 STATELINE RD
    COLCORD, OK
    ZIP 74338
  • Phone: (918) 203-0004

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NPI Details

PWWL CENTERS, LLC is a community health clinic center in Colcord, OK. PWWL CENTERS, LLC NPI is 1154198737. The provider is registered as an organization entity type.

The provider's business location address is:

644 STATELINE RD
COLCORD, OK
ZIP 74338-344
Phone: (918) 203-0004

The provider's authorized official is Jerry Dale Frederiksen .
The authorized official title is Managing Member and has the following contact phone number (479) 459-6354.

The enumeration date for this NPI number is 12/5/2023 and was last updated on 12/5/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QC1500XClinic/CenterCommunity HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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