Organization
ST JOHN SAPULPA, INC
Active
Parent organization
ST JOHN SAPULPA, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST JOHN SAPULPA, INC.
Authorized official
MR. DAVID L. PHILLIPS (COO)
(918) 227-8601
Entity
Organization
Contact information
Practice address
1004 E BRYAN AVE, SAPULPA, OK 74066-4513
(918) 224-4280
(918) 224-6290
Mailing address
PO BOX 1368, SAPULPA, OK 74067-1368
(918) 224-4280
(918) 224-6290
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
2310
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000370033001
BLUE CROSS BLUE SHIELD
OK
05
—
100699550
—
OK
Enumeration date
06/04/2008
Last updated
01/23/2014
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