Shawnee Rt Associates LLC
in Oklahoma City, OK. Organization (NPI-2).
NPI number1649595166
StatusActive
Last updated in NPPESMar 29, 2010
Details
- NPI
- 1649595166
- Entity type
- Organization (NPI-2)
- Legal business name
- Shawnee Rt Associates LLC
- Organization subpart
- No
- Enumeration date
- Mar 29, 2010
- Last updated
- Mar 29, 2010
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0001X | – | – | Yes |
Practice location
3700 N Kickapoo AveSte 108
Oklahoma City, OK 74804-0007
Phone 405-418-2200 · Fax 405-418-2201
Mailing address
11101 Hefner Pointe Dr#232
Oklahoma City, OK 73120-5054
Phone 405-418-2200 · Fax 405-418-2201
Authorized official
Derek M Prentice
Managing Member
4054182200
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