MEDICARE: FEDERAL TRANSFER CENTER OKLAHOMA CITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2400X	Prison Health Clinic/Center

General Provider Information

NPI Number	:	1720612443
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FEDERAL TRANSFER CENTER OKLAHOMA CITY

Provider Business Mailing Address
First Line	:	PO BOX 898802
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73189-8802
Country	:	US
Telephone Number	:	405-682-4075
Fax Number	:	405-680-4095

Provider Business Practice Location Address
First Line	:	7410 S MACARTHUR BLVD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73169-6908
Country	:	US
Telephone Number	:	405-682-4075
Fax Number	:	405-680-4095

Authorized Official
Title or Position	:	CHIEF PHARMACIST
Name	:	BRIAN DAN HAMBURGER
Credential	:	PHARMD
Telephone Number	:	405-680-4075

Provider Enumeration Date	:	03/03/2020
Last Update Date	:	03/03/2020

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