MEDICAL CENTER OF SOUTHEAST OKLAHOMA (NPI# 1083650600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083650600 |
| Entity Type | Organization |
| Organization Name | MEDICAL CENTER OF SOUTHEAST OKLAHOMA |
| Other Organization Name | MEDICAL CENTER OF SE OKLAHOMA |
| Practice Address |
1800 W University Blvd Durant OK 74701-3006 |
| Practice Telephone | 5809243080 |
| Practice Fax Number | 5809200119 |
| Mailing Telephone | 5809243080 |
| Mailing Fax Number | 5809200119 |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2010-06-09 |
| Authorized Official Name | JOHN HARMS (PHCY DIR) |
| Authorized Official Telephone | 5809243080 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336I0012X |
Pharmacy Specialization: Institutional Pharmacy |
274441 | OK | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 3720249 | 01 | |
| OK | 100696610B | 05 |
| Other Name | Type Code |
|---|---|
| MEDICAL CENTER OF SE OKLAHOMA | Doing Business As Name - Organization |
| Street Address |
1800 W UNIVERSITY BLVD |
| City | DURANT |
| State | OK |
| Zip Code | 74701-3006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720033087 | Neon Clinic Inc | Specialist | 1800 W University Blvd, Durant, OK 74701-3006 | 2006-05-24 |
| 1003375650 | Anesthesia Management Solutions of Oklahoma Pllc | Nurse Anesthetist, Certified Registered | 1800 W University Blvd, Durant, OK 74701-3006 | 2019-03-13 |
| 1285190322 | Nelson Scott Edgeman | Pharmacist | 1800 W University Blvd, Durant, OK 74701-3006 | 2019-02-13 |
| 1306317078 | Sean Phillip Klufa | Nurse Anesthetist, Certified Registered | 1800 W University Blvd, Durant, OK 74701-3006 | 2018-12-06 |
| 1912478769 | Lake Texoma Physician Services, PC | Physician Assistant | 1800 W University Blvd, Durant, OK 74701-3006 | 2018-12-05 |
| 1255830881 | Durant Anesthesia Services LLC | Nurse Anesthetist, Certified Registered | 1800 W University Blvd, Durant, OK 74701-3006 | 2018-02-09 |
| 1649717091 | Blake Randall Ridgway | Nurse Anesthetist, Certified Registered | 1800 W University Blvd, Durant, OK 74701-3006 | 2017-01-24 |
| 1942654819 | Shawn Idell | Dietitian, Registered | 1800 W University Blvd, Durant, OK 74701-3006 | 2016-04-18 |
| 1780922443 | Krista Danielle Ribera | Nurse Practitioner | 1800 W University Blvd, Durant, OK 74701-3006 | 2013-01-30 |
| 1891039764 | Oklahoma Emergency Physician Partners Pllc | Emergency Medicine | 1800 W University Blvd, Durant, OK 74701-3006 | 2012-11-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134738362 | Elevate Therapy, Pllc | Physical Therapist | 523 N Wshington Ave, Durant, OK 74701 | 2020-07-23 |
| 1093334906 | Duncan Kovash | Nurse Practitioner | 1901 Chukka Hina, Durant, OK 74701 | 2020-04-10 |
| 1184193690 | Inventive Therapy Services, LLC | Occupational Therapist | 2620 Maxey Dr, Durant, OK 74701 | 2018-11-14 |
| 1790271831 | Jazmine Gabrielle Benavidez | Specialist/Technologist | 1713 North 1st Avenue, Durant, OK 74701 | 2018-07-02 |
| 1538659586 | Katelen Sue Morgan | Case Manager/Care Coordinator | 1011 Donna Sue Pl, Durant, OK 74701 | 2018-05-15 |
| 1164941035 | Nsight for Life LLC | Community/Behavioral Health | 1313 N 16th, Durant, OK 74701 | 2017-09-12 |
| 1023534666 | Damon Dye | Physical Therapist | 30 W 3rd St, Durant, OK 74701 | 2017-08-15 |
| 1437605250 | Casey Worsham | Nurse Practitioner | 1800 W University, Durant, OK 74701 | 2016-08-31 |
| 1083160857 | Denise Adanho | Case Manager/Care Coordinator | 1218 Stonebrook Circle, Durant, OK 74701 | 2016-08-31 |
| 1962850271 | Justi Thompson | Case Manager/Care Coordinator | 4817 Ciara St, Durant, OK 74701 | 2016-05-26 |
| Find all providers in zip 74701 | ||||
| Taxonomy Code | 3336I0012X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Institutional Pharmacy |
| A pharmacy in a hospital (inpatient) or institution used by pharmacists for the compounding and delivery of medicinal preparations to be administered to the patient by nursing or other authorized personnel. Institutional Pharmacies also counsel patients and caregivers; administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811229966 | Us Dept of Justice | Pharmacy | 4205 E Highway 66, El Reno, OK 73036-9701 | 2010-01-31 |
| 1710174107 | Northwest Center for Behavioral Health | Pharmacy | 1 Mi E Hwy 270, Fort Supply, OK 73841-0001 | 2007-09-28 |
| 1992134852 | Mercy Hospital Ada Pharmacy | Pharmacy | 430 N Monte Vista St, Ada, OK 74820-4610 | 2013-11-01 |
| 1528383841 | Shadow Mountain Behavioral Health System, LLC | Pharmacy | 1027 E 66th Pl, Tulsa, OK 74136-3701 | 2010-03-30 |
| 1235346479 | Tulsa Spine & Specialty Hospital Pharmacy | Pharmacy | 6901 S Olympia Ave, Tulsa, OK 74132 | 2007-05-17 |
| 1558582387 | Moore Medical Center | Pharmacy | 700 S Telephone Rd, Moore, OK 73160-2502 | 2007-05-01 |
| 1518028380 | Jackson County Memorial Hosp Phcy | Pharmacy | 1200 E Pecan St, Altus, OK 73521-6141 | 2006-12-13 |
| 1437226917 | Owasso Medical Facility LLC | Pharmacy | 12451 E 100th St N, Owasso, OK 74055-4600 | 2006-11-29 |
| 1285727446 | State of Oklahoma Office of State Finance | Pharmacy | 1101 E Monroe Ave, Mcalester, OK 74501-4815 | 2006-10-02 |
| 1285739045 | Norman Regional Hospital | Pharmacy | 901 N Porter, Norman, OK 73071-6404 | 2006-09-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.