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NPI Code Detail

MEDICARE: AHS SOUTHCREST HOSPITAL, LLC

MEDICARE: AHS SOUTHCREST HOSPITAL, LLC
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
1282N00000XGeneral Acute Care Hospital2337OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750661534
Entity Type Code : Organization
Provider Name (Legal Business Name) : AHS SOUTHCREST HOSPITAL, LLC
Provider Business Mailing Address
First Line : 8801 S 101ST EAST AVE
Second Line :
City : TULSA
State : OK
Zip : 74133-5716
Country : US
Telephone Number : 918-294-4000
Fax Number : 918-294-4809
Provider Business Practice Location Address
First Line : 8801 S 101ST EAST AVE
Second Line :
City : TULSA
State : OK
Zip : 74133-5716
Country : US
Telephone Number : 918-294-4000
Fax Number : 615-294-4809
Authorized Official
Title or Position : SVP, GENERAL COUNSEL
Name : MR. STEPHEN C. PETROVICH
Credential :
Telephone Number : 615-296-3594
Provider Enumeration Date : 08/24/2011
Last Update Date : 04/06/2026

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