Organization
ST. JOHN MEDICAL CENTER
Active
Other names
SJMC RCU
Organization subpart
No
Provider details
NPI number
Authorized official
SR. M. THERESE GOTTSCHALK (PRESIDENT/CHIEF EXECUTIVE OFFICER)
(918) 744-2180
Entity
Organization
Contact information
Practice address
1923 S UTICA AVE, TULSA, OK 74104
(918) 744-2345
Mailing address
1923 S UTICA AVE, TULSA, OK 74104
(918) 744-2345
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2265
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000375069001
BCBS OF OK
OK
Enumeration date
10/04/2006
Last updated
08/22/2020
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