Northeastern Health System

NPI #1104567791 in Tahlequah, Oklahoma

Provider Information

NPI Number
1104567791
Entity Type
Organization
Organization Name
Northeastern Health System
Subpart
Yes (part of a larger organization)
Parent Organization
NORTHEASTERN HEALTH SYSTEM
Primary Specialty
Medicare Defined Swing Bed Unit
Enumeration Date
Apr 6, 2022
Last Updated
Apr 6, 2022

Practice Location

Address
1400 E DOWNING ST
ZIP Code
74464-3324
Phone
(918) 456-0641

Authorized Official

Name
JAMES THEODORE BERRY
Title
EVP/HOSPITAL ADMINISTRATOR
Phone
(918) 453-2263

Specialties & Taxonomy Codes

Specialty
Medicare Defined Swing Bed Unit

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