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Organization

BRISTOW HEALTHCARE PROPERTIES LLC

Active
Parent organization
BRISTOW HEALTHCARE PROPERTIES LLC
Other names
Bristow Medical Center Home Health
Organization subpart
Yes

Provider details

NPI number
Legal business name
BRISTOW HEALTHCARE PROPERTIES LLC
Authorized official
MS. DEBBIE K CUPPS RN (DIRECTOR)
(918) 367-5644
Entity
Organization

Contact information

Practice address
124 W 4TH AVE, BRISTOW, OK 74010-2823
(918) 367-5644
(918) 367-2437
Mailing address
124 W 4TH AVE, BRISTOW, OK 74010-2823
(918) 367-5644
(918) 367-2437

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
7143
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0003772660001
BLUE CROSS BLUE SHIELD
OK
05
200044170B
OK
Enumeration date
11/01/2006
Last updated
12/31/2008
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