Basic Information
| Provider Information | |||||||||
| NPI: | 1114563699 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AIM HEALTH CLINICS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 12883 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731572883 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4058580600 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2301 W I 44 SERVICE RD STE 310 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731128729 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4058580600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2019 | ||||||||
| LastUpdateDate: | 01/28/2020 | ||||||||
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| AuthorizedOfficialLastName: | BATES | ||||||||
| AuthorizedOfficialFirstName: | JENNIER | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 4058580600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 01/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.