Provider Demographics
NPI:1679045439
Name:BRISTOW ENDEAVOR HEALTHCARE, LLC
Entity Type:Organization
Organization Name:BRISTOW ENDEAVOR HEALTHCARE, LLC
Other - Org Name:DRUMRIGHT HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:WINTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-367-2215
Mailing Address - Street 1:900 OK-33 TRUCK
Mailing Address - Street 2:
Mailing Address - City:DRUMRIGHT
Mailing Address - State:OK
Mailing Address - Zip Code:74030
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 OK-33 TRUCK
Practice Address - Street 2:
Practice Address - City:DRUMRIGHT
Practice Address - State:OK
Practice Address - Zip Code:74030
Practice Address - Country:US
Practice Address - Phone:918-701-2302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRISTOW ENDEAVOR HEALTHCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-18
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty