Organization
OKLAHOMA HEART HOSPITAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY ENLOE (CFO)
(405) 608-3302
Entity
Organization
Contact information
Practice address
4050 W MEMORIAL RD, OKLAHOMA CITY, OK 73120-8382
(405) 608-3200
Mailing address
4050 W MEMORIAL RD, OKLAHOMA CITY, OK 73120-8382
(405) 608-3200
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
282N00000X
General Acute Care Hospital
Primary
—
—
284300000X
Special Hospital
2354
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000370215001
BLUE CROSS BLUE SHIELD OK
OK
05
—
200009170A
—
OK
Enumeration date
05/23/2005
Last updated
06/29/2023
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