Provider Demographics
NPI:1659673119
Name:OKLAHOMA PRIMARY CARE SOLUTIONS PC
Entity Type:Organization
Organization Name:OKLAHOMA PRIMARY CARE SOLUTIONS PC
Other - Org Name:SOLSTICE LIVING SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:D
Authorized Official - Last Name:BERRYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-268-2260
Mailing Address - Street 1:2642 E 21ST ST
Mailing Address - Street 2:SUITE 285
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-1716
Mailing Address - Country:US
Mailing Address - Phone:918-574-8820
Mailing Address - Fax:918-574-8821
Practice Address - Street 1:2642 E 21ST ST
Practice Address - Street 2:SUITE 285
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-1716
Practice Address - Country:US
Practice Address - Phone:918-574-8820
Practice Address - Fax:918-574-8821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-03
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty