OrganizationTeam Clinics Ah LlcClinic/CenterAmbulatory Health Care FacilitiesPractice Address405 E Richmond St, Broken Arrow, OK 74012-5642(405) 546-4130PECOS EnrollmentBased on the most recent information from CMS, provider Team Clinics Ah Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1386262335Provider TypeOrganizationFull NameTeam Clinics Ah LlcSubpartNoEnumeration Date7/7/2020Last Updated6/22/2021Contact InformationPractice LocationPractice Address405 E Richmond St, Broken Arrow, OK 74012-5642Phone(405) 546-4130FaxUnlisted FaxMailing LocationMailing Address3112 Cooke Way, Oklahoma City, OK 73179-2401Phone(405) 546-4130Fax(405) 600-6978Authorized OfficialNameNutt, Trevor (Ceo)Phone(405) 546-4130Provider TaxonomiesCodeDescriptionLicenseCode261QP2300XPrimaryDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID200782030DescriptionMedicaidIssuerUnlistedOklahoma