1073779328 NPI number — SAINT FRANCIS COMMUNITY SERVICES IN OKLAHOMA,

Table of content: (NPI 1073779328)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073779328 NPI number — SAINT FRANCIS COMMUNITY SERVICES IN OKLAHOMA,

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAINT FRANCIS COMMUNITY SERVICES IN OKLAHOMA,
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:
6
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:
1073779328
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
509 E ELM ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALINA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67401-2353
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-825-0541
Provider Business Mailing Address Fax Number:
785-825-0062

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7320 S YALE AVENUE
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-488-0163
Provider Business Practice Location Address Fax Number:
918-488-1583
Provider Enumeration Date:
08/05/2008

Additional Information

Authorized Official

Authorized Official Last Name:
PATRICK
Authorized Official First Name:
KRISTA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF ACCOUNTING SERVICES
Authorized Official Telephone Number:
785-825-0541

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  4634 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 1607 , 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)

  • Identifier: 200219080A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".




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