Healthcare Provider Details

I. General information

NPI: 1316361181
Provider Name (Legal Business Name): MERCY HOSPITAL MIDWEST CITY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2014
Last Update Date: 02/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 PARKLAWN DR
MIDWEST CITY OK
73110-4201
US

IV. Provider business mailing address

2825 PARKLAWN DR
MIDWEST CITY OK
73110-4201
US

V. Phone/Fax

Practice location:
  • Phone: 405-610-4411
  • Fax:
Mailing address:
  • Phone: 405-610-4411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MR. JONATHAN VITIELLO
Title or Position: CFO-MERCY HEALTH SYSTEM OKLAHOMA
Credential:
Phone: 405-752-3724