MEDICARE: OSU CENTER FOR HEALTH SCIENCES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1346824885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSU CENTER FOR HEALTH SCIENCES

Provider Business Mailing Address
First Line	:	2345 SOUTHWEST BLVD
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74107-2705
Country	:	US
Telephone Number	:	918-561-8306
Fax Number	:	918-561-5747

Provider Business Practice Location Address
First Line	:	5414 W PINNACLE POINTE DR STE 300
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-8956
Country	:	US
Telephone Number	:	918-561-8306
Fax Number	:	918-561-5747

Authorized Official
Title or Position	:	VICE PRESIDENT OF ADMIN/FINANCE
Name	:	ERIC JOHN POLAK
Credential	:
Telephone Number	:	918-561-8422

Provider Enumeration Date	:	05/11/2021
Last Update Date	:	05/11/2021

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Directions to “OSU CENTER FOR HEALTH SCIENCES ” Practice Location

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