Healthcare Provider Details

I. General information

NPI: 1134099617
Provider Name (Legal Business Name): GREAT SALT PLAINS HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2025
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 S 30TH ST
ENID OK
73701-6455
US

IV. Provider business mailing address

205 W MAPLE AVE STE 1000
ENID OK
73701-4047
US

V. Phone/Fax

Practice location:
  • Phone: 580-233-2900
  • Fax:
Mailing address:
  • Phone: 580-596-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY STARKEY
Title or Position: CEO
Credential:
Phone: 580-215-1766