Healthcare Provider Details

I. General information

NPI: 1841442274
Provider Name (Legal Business Name): OKLAHOMA HEART HOSPITAL SOUTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2008
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 EAST I-240 SERVICE RD
OKLAHOMA CITY OK
73135-2610
US

IV. Provider business mailing address

7800 NW 85TH TER
OKLAHOMA CITY OK
73132-3385
US

V. Phone/Fax

Practice location:
  • Phone: 405-595-5000
  • Fax: 405-608-6174
Mailing address:
  • Phone: 405-608-1200
  • Fax: 405-608-1830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: TRACY ENLOE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 405-608-3302