Provider Demographics
NPI:1255509188
Name:BIOMEDICAL APPLICATION OF OKLA
Entity Type:Organization
Organization Name:BIOMEDICAL APPLICATION OF OKLA
Other - Org Name:FMC NORTH TULSA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO AREA MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROCKY
Authorized Official - Middle Name:H
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-878-9300
Mailing Address - Street 1:3807 N HARRISON
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804
Mailing Address - Country:US
Mailing Address - Phone:405-878-9300
Mailing Address - Fax:405-395-9362
Practice Address - Street 1:2309A WEST EDISON
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127-5218
Practice Address - Country:US
Practice Address - Phone:405-878-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIOMEDICAL APPLICATION OF OKLA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment