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General NPI Number Information
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NPI Number | 1720357841
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Entity Type | Organization
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Legal Business Name | OKLAHOMA BLOOD INSTITUTE
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Dates
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Enumeration Date | 12/19/2011
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Last Update Date | 12/19/2011
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Provider Practice Location Address
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Address Line | 1001 N LINCOLN BLVD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-3251
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Country | US
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Telephone | 405-297-5511
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Fax | 405-228-9911
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Provider Business Mailing Address
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Address Line | 1001 N LINCOLN BLVD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-3251
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Country | US
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Telephone | 405-297-5511
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Fax | 405-228-9911
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | RANDALL G STARK
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Credential |
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Telephone | 405-297-5501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 331L00000X
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Taxonomy Name | Blood Bank
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License Number | 37D0470358
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License Number State | OK
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