Provider Demographics
NPI:1144278920
Name:SEMINOLE HEALTH CENTER LLC
Entity type:Organization
Organization Name:SEMINOLE HEALTH CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-917-0300
Mailing Address - Street 1:1266 PAYSPHERE CIR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-0012
Mailing Address - Country:US
Mailing Address - Phone:877-238-2363
Mailing Address - Fax:405-917-0331
Practice Address - Street 1:2401 W WRANGLER BLVD
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:OK
Practice Address - Zip Code:74868-1917
Practice Address - Country:US
Practice Address - Phone:405-303-4000
Practice Address - Fax:405-303-4150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered282N00000XHospitalsGeneral Acute Care Hospital
Not Answered275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK37U200Medicare Oscar/Certification
OK370200Medicare ID - Type UnspecifiedUB BILLING