Provider Demographics
NPI:1861254104
Name:NATURAL MEDICINE INC
Entity type:Organization
Organization Name:NATURAL MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELDON
Authorized Official - Middle Name:
Authorized Official - Last Name:ST CLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:C ACU
Authorized Official - Phone:918-439-4344
Mailing Address - Street 1:3401 E 21ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-1958
Mailing Address - Country:US
Mailing Address - Phone:918-439-4434
Mailing Address - Fax:
Practice Address - Street 1:3401 E 21ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-1958
Practice Address - Country:US
Practice Address - Phone:918-439-4434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center