# HEARTLAND TRAVEL HEALTH SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Passport Health of Oklahoma
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013277979
- **Authorized official:** DR. BRET RICE HAYMORE M.D (MEDICAL DIRECTOR)
- **Authorized official phone:** (405) 563-8961

## Contact information

- **Practice address:** 3545 NW 58TH ST, SUIT 340, OKLAHOMA CITY, OK 73112-4726
- **Practice address phone:** (888) 528-9521
- **Practice address fax:** (888) 521-6702
- **Mailing address:** 3545 NW 58TH ST, SUIT 340, OKLAHOMA CITY, OK 73112-4726
- **Mailing address phone:** (888) 528-9521
- **Mailing address fax:** (888) 521-6702

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 28286 | OK | Yes |

## Other

- **Enumeration date:** 05/24/2012
- **Last updated:** 07/23/2012