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General NPI Number Information
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NPI Number | 1083617005
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Entity Type | Organization
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Legal Business Name | OKLAHOMA HEART HOSPITAL, LLC
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 4050 W MEMORIAL RD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120-8382
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Country | US
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Telephone | 405-608-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 4050 W MEMORIAL RD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120-8382
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Country | US
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Telephone | 405-608-3200
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | TRACY ENLOE
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Credential |
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Telephone | 405-608-3302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | 2354
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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