1326117888 NPI number — OKLAHOMA REHAB SERVICES, INC.

Table of content: (NPI 1326117888)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326117888 NPI number — OKLAHOMA REHAB SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OKLAHOMA REHAB SERVICES, 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:
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:
1326117888
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4833 S SHERIDAN RD
Provider Second Line Business Mailing Address:
SUITE 414
Provider Business Mailing Address City Name:
TULSA
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74145-5750
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-488-9992
Provider Business Mailing Address Fax Number:
918-488-9993

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4833 S SHERIDAN RD
Provider Second Line Business Practice Location Address:
SUITE 414
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74145-5750
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-488-9992
Provider Business Practice Location Address Fax Number:
918-488-9993
Provider Enumeration Date:
11/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DANIEL
Authorized Official First Name:
BOBBY
Authorized Official Middle Name:
N
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
918-488-9992

Provider Taxonomy Codes

  • Taxonomy code: 261QR0401X , with the licence number:  OK1843 , 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: 000374507001 . This is a "BCBS" identifier , issued by the state of ( OK ) . This identifiers is of the category "OTHER".
  • Identifier: 100748900C , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 611954700 . This is a "US DEPT OF LABOR" identifier , issued by the state of ( OK ) . This identifiers is of the category "OTHER".
  • Identifier: 700522047 . This is a "MEDICARE PART B" identifier , issued by the state of ( OK ) . This identifiers is of the category "OTHER".
  • Identifier: 731596739 . This is a "TRICARE" identifier , issued by the state of ( OK ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com