Organization
ST ANTHONY NORTH AMBULATORY SURGICAL CENTER L L C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEBBIE FOSTER (CEO)
(405) 419-5566
Entity
Organization
Contact information
Practice address
6205 N SANTA FE AVE, SUITE 100, OKLAHOMA CITY, OK 73118-7535
(405) 419-5566
(405) 419-5401
Mailing address
6205 N SANTA FE AVE, SUITE 100, OKLAHOMA CITY, OK 73118-7535
(405) 419-5566
(405) 419-5410
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0055
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100745740B
—
OK
01
—
490004237
RAILROAD MEDICARE ID
OK
Enumeration date
03/27/2006
Last updated
04/30/2008
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