NORTHEASTERN HEALTH SYSTEM NPI 1871717819

NPI Information

NPI: 1871717819
Provider Name: NORTHEASTERN HEALTH SYSTEM

Former Legal Business Name: TAHLEQUAH HOSPITAL AUTHORITY

Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

Address:
1400 E DOWNING ST
TAHLEQUAH, OK
ZIP 74464
Phone: (918) 456-0641
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NORTHEASTERN HEALTH SYSTEM is a land transport ambulance in Tahlequah, OK. NORTHEASTERN HEALTH SYSTEM NPI is 1871717819. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Tahlequah Hospital Authority.

The provider's business location address is:

1400 E DOWNING ST
TAHLEQUAH, OK
ZIP 74464-324
Phone: (918) 456-0641
Fax: (918) 456-8886

The provider's authorized official is Brian Woodliff .
The authorized official title is Ceo and has the following contact phone number (918) 456-0641.

The enumeration date for this NPI number is 4/12/2007 and was last updated on 8/6/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3416L0300X	Ambulance	Land Transport	2178	OKLAHOMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100700680B	MEDICAID	OKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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