1083985600 NPI number — UHS OKLAHOMA CITY LLC

Table of content: (NPI 1083985600)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083985600 NPI number — UHS OKLAHOMA CITY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UHS OKLAHOMA CITY LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CEDAR RIDGE BEHAVIORAL HOSPITAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083985600
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/31/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6501 NE 50TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73141-9118
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-605-6111
Provider Business Mailing Address Fax Number:
405-424-0457

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6501 NE 50TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OKLAHOMA CITY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73141-9118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-605-6111
Provider Business Practice Location Address Fax Number:
405-424-0457
Provider Enumeration Date:
01/13/2012

Additional Information

Authorized Official

Authorized Official Last Name:
FILTON
Authorized Official First Name:
STEVE
Authorized Official Middle Name:
Authorized Official Title or Position:
SR VP CFO
Authorized Official Telephone Number:
610-768-3300

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  4246 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363A00000X , with the licence number: 1444 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0200X , with the licence number: 47346 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100544890C , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200085660B , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200085660D , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200085660A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200085660C , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".




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