Provider Demographics
NPI:1104824440
Name:BROKEN ARROW MEDICAL CENTER INC
Entity Type:Organization
Organization Name:BROKEN ARROW MEDICAL CENTER INC
Other - Org Name:SAINT FRANCIS HOSPITAL AT BROKEN ARROW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, PATIENT FINANCIAL SERVICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:I
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-502-8010
Mailing Address - Street 1:6600 S YALE AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3310
Mailing Address - Country:US
Mailing Address - Phone:918-502-8010
Mailing Address - Fax:918-502-8002
Practice Address - Street 1:3000 S ELM PL
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-7917
Practice Address - Country:US
Practice Address - Phone:918-451-5148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2259282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR131748105Medicaid
KS200260350AMedicaid
607211000OtherUS DEPT OF LABOR
CAXHSP42794OtherMEDICAID - OUTPATIENT
OK000370176001OtherBLUE CROSS
OK100699930AMedicaid
AZ109325Medicaid
CAXHSP32794OtherMEDICAID - INPATIENT
NE10025422600Medicaid
KS200260350AMedicaid
OK370176Medicare ID - Type Unspecified