Organization
BASS MEMORIAL BAPTIST HOSPITAL DBA INTEGRIS BASS BAPTIST HEALTH CENTER
Active
Other names
Advance Food Company Employee's Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CARL B. LAWRENCE (PRESIDENT AND CEO)
(405) 951-2616
Entity
Organization
Contact information
Practice address
915 E GARRIOTT RD, SUITE D, ENID, OK 73701-6156
(580) 234-8998
(580) 234-8465
Mailing address
PO BOX 5038, ENID, OK 73702-5038
(580) 548-1367
(580) 548-1583
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37D1036503
CLIA
OK
Enumeration date
07/31/2006
Last updated
12/19/2011
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