| St John Medical Center Inc | |
|
1923 S Utica Ave Tulsa OK 74104-6520 | |
| (918) 744-2345 | |
| Not Available |
| Full Name | St John Medical Center Inc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1923 S Utica Ave, Tulsa, Oklahoma |
| Authorized Official Name and Position | Sr. M. Therese Gottschalk (PRESIDENT/CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9187442180 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St John Medical Center Inc 1923 S Utica Ave Tulsa OK 74104-6520 Ph: (918) 744-2345 | St John Medical Center Inc 1923 S Utica Ave Tulsa OK 74104-6520 Ph: (918) 744-2345 |
| NPI Number | 1144306382 |
|---|---|
| Provider Enumeration Date | 10/31/2006 |
| Last Update Date | 11/10/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144306382 | NPI | - | NPPES |
| 74104 0000 | Other | OK | CHAMPUS |
| 00370114001 | Other | OK | BCBS |
| 100699400A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 2265 (Oklahoma) | Primary |
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