Provider Demographics
NPI:1003359662
Name:DE FOUNDATION HEALTH INC
Entity Type:Organization
Organization Name:DE FOUNDATION HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GINNY
Authorized Official - Middle Name:E
Authorized Official - Last Name:ONUOHA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:405-606-2528
Mailing Address - Street 1:1900 N MACARTHUR BLVD
Mailing Address - Street 2:SUITE 101 DEPT. A
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127-2617
Mailing Address - Country:US
Mailing Address - Phone:405-606-2528
Mailing Address - Fax:405-606-2531
Practice Address - Street 1:1900 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 101 DEPT.A
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-2617
Practice Address - Country:US
Practice Address - Phone:405-606-2528
Practice Address - Fax:405-606-2531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKK080087766302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization