NPIMap

Organization Active NPI

Medical Center of Southeast Oklahoma

  • Institutional Pharmacy
  • Durant, OK
National Provider Identifier
1083650600
Registry record updated Jun 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
274441 Issued in OK
Legal business name
MEDICAL CENTER OF SOUTHEAST OKLAHOMA
Practice address
1800 W University Blvd
Durant, OK 74701-3006
Phone
(580) 924-3080
Fax
(580) 920-0119
NPI assigned
Jun 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John Harms
Title
Phcy Dir
Phone
(580) 924-3080

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Institutional Pharmacy 3336I0012X 274441 OK Primary

Addresses

Primary practice location

1800 W University Blvd
Durant, OK 74701-3006

Mailing address

1800 W University Blvd
Durant, OK 74701-3006
Phone (580) 924-3080

Other identifiers 2

IdentifierTypeStateIssuer
3720249OtherNCPDP PROVIDER IDENTIFICATION NUMBER
100696610BMedicaidOK

Other names 1

  • MEDICAL CENTER OF SE OKLAHOMA Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medical Center of Southeast Oklahoma3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276041600000",
    "number": "1083650600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 W UNIVERSITY BLVD",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747013006",
            "telephone_number": "580-924-3080",
            "fax_number": "580-920-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 W UNIVERSITY BLVD",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747013006",
            "telephone_number": "580-924-3080",
            "fax_number": "580-920-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER OF SOUTHEAST OKLAHOMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2010-06-09",
        "status": "A",
        "authorized_official_last_name": "HARMS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PHCY DIR",
        "authorized_official_telephone_number": "580-924-3080"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "OK",
            "license": "274441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3720249",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100696610B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICAL CENTER OF SE OKLAHOMA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Durant, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.