OSU-AJ INTEGRIS GRAND LAKE ENT – NPI #1083049001
Clinic/Center

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

OSU-AJ INTEGRIS GRAND LAKE ENT is an AHC clinic located in GROVE, OK. NPPES has assigned the NPI number 1083049001 to OSU-AJ INTEGRIS GRAND LAKE ENT on September 10, 2013. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “OSU-AJ INTEGRIS GRAND LAKE ENT” is a dba name, the actual legal business name for this organization is OSU CENTER FOR HEALTH SCIENCES. The primary taxonomy selected by this provider is 261Q00000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center.

The NPI profile was previously updated about 10 years ago on Aug 20, 2016. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for OSU-AJ INTEGRIS GRAND LAKE ENT below.

NPI Profile for
OSU CENTER FOR HEALTH SCIENCES

NPI Number
1083049001
Enumeration Date

(about 13 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
OSU CENTER FOR HEALTH SCIENCES
Doing Business As (dba): OSU-AJ INTEGRIS GRAND LAKE ENT
Primary location
900 E 13TH ST
SUITE 201
GROVE, OK 74344-2976
Phone: (918) 561-8306 Fax: (918) 561-5747
Mailing address
2345 SOUTHWEST BLVD
TULSA, OK 74107-2705
Phone: (918) 561-8306 Fax: (918) 561-5747
Organization Subpart
No
Authorized Official
ERIC POLAK
CFO OSU PHYSICIANS
Phone: (918) 561-8422
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261Q00000X
- Clinic/Center (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.