Healthcare Provider Details

I. General information

NPI: 1124040217
Provider Name (Legal Business Name): BAPTIST HEALTHCARE OF OKLAHOMA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 05/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL DRIVE
MADILL OK
73446-0827
US

IV. Provider business mailing address

PO BOX 827
MADILL OK
73446-0827
US

V. Phone/Fax

Practice location:
  • Phone: 580-795-9917
  • Fax: 580-795-0171
Mailing address:
  • Phone: 580-795-3384
  • Fax: 580-795-0171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number4025
License Number StateOK

VIII. Authorized Official

Name: TOM BRIGGS
Title or Position: CFO
Credential:
Phone: 580-795-0177