# ST. JOHN MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SJMC RCU
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154416188
- **Authorized official:** SR. M. THERESE GOTTSCHALK (PRESIDENT/CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (918) 744-2180

## Contact information

- **Practice address:** 1923 S UTICA AVE, TULSA, OK 74104
- **Practice address phone:** (918) 744-2345
- **Mailing address:** 1923 S UTICA AVE, TULSA, OK 74104
- **Mailing address phone:** (918) 744-2345

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 2265 | OK | Yes |

## Other

- **Enumeration date:** 10/04/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000375069001 | BCBS OF OK | OK |