Basic Information
| Provider Information | |||||||||
| NPI: | 1841442274 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OKLAHOMA HEART HOSPITAL SOUTH LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7800 NW 85TH TER | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731323385 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4056083300 | ||||||||
| FaxNumber: | 4056081550 | ||||||||
| Practice Location | |||||||||
| Address1: | 5200 EAST I-240 SERVICE RD | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731352610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4055955000 | ||||||||
| FaxNumber: | 4056086174 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2008 | ||||||||
| LastUpdateDate: | 03/23/2016 | ||||||||
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| AuthorizedOfficialLastName: | WALKER | ||||||||
| AuthorizedOfficialFirstName: | CAROL | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 4056083302 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 284300000X | Y | Hospitals | Special Hospital |
No ID Information.