Organization Name:  STATE OF OKLAHOMA


Practice Location:
900 E MAIN ST  NORMAN, OK 73071 US
Tel: 405-573-6600  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
N	3336L0003X	Suppliers Pharmacy Long Term Care Pharmacy	OK	7-1002
N	261QM2500X	Ambulatory Health Care Facilities Clinic/Center	OK
Y	283Q00000X	Hospitals Psychiatric Hospital	OK

Other Provider Identifiers:

Issuer	Number	State	Type
BCBS NUMBER	000374000001	OK	01
	100690030A	OK	05
	100709440A	OK	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin