OrganizationBroken Arrow Family Practice Center PlcClinic/CenterAmbulatory Health Care FacilitiesPractice Address817 S Elm Pl, Suite A, Broken Arrow, OK 74012-5369(918) 251-2273PECOS EnrollmentBased on the most recent information from CMS, provider Broken Arrow Family Practice Center Plc 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 ID1790127900Provider TypeOrganizationFull NameBroken Arrow Family Practice Center PlcSubpartNoEnumeration Date7/29/2013Last Updated7/29/2013Contact InformationPractice LocationPractice Address817 S Elm Pl, Suite A, Broken Arrow, OK 74012-5369Phone(918) 251-2273Fax(918) 258-6446Mailing LocationMailing Address817 S Elm Pl, Suite A, Broken Arrow, OK 74012-5369Phone(918) 251-2273Fax(918) 258-6446Authorized OfficialNameHolte, Douglas William (President Of Bafpc Plc)Phone(918) 251-2273Provider TaxonomiesCodeDescriptionLicenseCode261QP2300XPrimaryDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicense15244Oklahoma