NPIMap

Organization Active NPI

Osu Center for Health Sciences

  • Medical Specialty Clinic/Center
  • Stillwater, OK
National Provider Identifier
1508046111
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
OSU CENTER FOR HEALTH SCIENCES
Practice address
1921 W 6TH Ave
Suite a
Stillwater, OK 74074-4204
Phone
(918) 561-8306
Fax
(918) 561-5747
NPI assigned
Nov 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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

Authorized official

Name
Eric Polak
Title
Vice President for Admin/Finance
Phone
(918) 561-8422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

1921 W 6TH Ave
Suite a
Stillwater, OK 74074-4204

Mailing address

2345 Southwest Blvd
Tulsa, OK 74107-2705
Phone (918) 561-8306

Other names 1

  • OSU-AJ STILLWATER FAMILY CARE Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D1002748Stillwater Family Care1921 West 6TH Street, Ste a, Stillwater, OK 74074Certificate of waiverJan 5, 2028

National Provider Directory

National Provider Directory
Tax ID family
Oklahoma State University223 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459123200000",
    "number": "1508046111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 SOUTHWEST BLVD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741072705",
            "telephone_number": "918-561-8306",
            "fax_number": "918-561-5747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 W 6TH AVE",
            "address_2": "SUITE A",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744204",
            "telephone_number": "918-561-8306",
            "fax_number": "918-561-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSU CENTER FOR HEALTH SCIENCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-12",
        "last_updated": "2016-03-28",
        "status": "A",
        "authorized_official_last_name": "POLAK",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "VICE PRESIDENT FOR ADMIN/FINANCE",
        "authorized_official_telephone_number": "918-561-8422"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OSU-AJ STILLWATER FAMILY CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stillwater, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.