Healthcare Provider Details

I. General information

NPI: 1902170921
Provider Name (Legal Business Name): MCALESTER SCOTTISH RITE CHARITABLE AND EDUCATIONAL FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2012
Last Update Date: 03/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 N. 2ND ST
MCALESTER OK
74502-0609
US

IV. Provider business mailing address

305 N. 2ND ST
MCALESTER OK
74502-0609
US

V. Phone/Fax

Practice location:
  • Phone: 918-426-2300
  • Fax: 918-423-6362
Mailing address:
  • Phone: 918-426-2300
  • Fax: 918-423-6362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN ALLFORD
Title or Position: GENERAL SECRETARY
Credential:
Phone: 918-423-6360