Provider Demographics
NPI:1437256070
Name:MERCY HOSPITAL OKLAHOMA CITY, INC.
Entity Type:Organization
Organization Name:MERCY HOSPITAL OKLAHOMA CITY, INC.
Other - Org Name:MERCY HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HAHNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-936-5649
Mailing Address - Street 1:4300 W MEMORIAL RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8304
Mailing Address - Country:US
Mailing Address - Phone:405-752-3724
Mailing Address - Fax:405-752-3811
Practice Address - Street 1:4401 W MEMORIAL RD STE 143
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-1787
Practice Address - Country:US
Practice Address - Phone:405-486-8600
Practice Address - Fax:405-752-3598
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY HOSPITAL OKLAHOMA CITY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-17
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7207251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK000377048-001OtherBC/BS # - HOME HEALTH
OK100699390BMedicaid
OK37-7048Medicare Oscar/Certification