1376682179 NPI number — P & S HEALTHCARE SYSTEMS INC

Table of content: (NPI 1376682179)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376682179 NPI number — P & S HEALTHCARE SYSTEMS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
P & S HEALTHCARE SYSTEMS INC
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:
Provider Other Organization Name Type Code:
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:
1376682179
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
900 N PORTER AVE
Provider Second Line Business Mailing Address:
SUITE 104
Provider Business Mailing Address City Name:
NORMAN
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73071
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-329-5492
Provider Business Mailing Address Fax Number:
405-321-2472

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 N PORTER AVE
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
NORMAN
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73071-6425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-329-5492
Provider Business Practice Location Address Fax Number:
405-321-2472
Provider Enumeration Date:
02/06/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MCCULLOUGH
Authorized Official First Name:
GERALD
Authorized Official Middle Name:
W
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
405-329-2442

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  700066 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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