Organization
BRISTOW HEALTHCARE PROPERTIES, LLC
Active
Other names
Bristow Memorial Center
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID M JAMIN (CEO CFO)
(918) 367-4418
Entity
Organization
Contact information
Practice address
700 W 7TH AVE, SUITE 6, BRISTOW, OK 74010-2302
(918) 367-2215
(918) 392-1995
Mailing address
700 W 7TH AVE, SUITE 6, BRISTOW, OK 74010-2302
(918) 367-2215
(918) 392-1995
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
2308
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000370041001
BCBS OKLAHOMA
OK
05
—
200044170A
—
OK
01
—
400522419
MEDICARE PART B (LEGACY)
OK
Enumeration date
02/23/2006
Last updated
10/02/2008
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