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DSH370078 OKLAHOMA STATE UNIVERSITY MEDICAL CENTER TRUST (Active)
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Main Details
Name
OKLAHOMA STATE UNIVERSITY MEDICAL CENTER TRUST
Subdivision Name
DBA OKLAHOMA STATE UNIVERSITY MEDICAL CENTER
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH370078
Medicare Provider Number
370078
Additional Details
Current Program Status
Active
Registration Date
6/3/2009
Participating Start Date
7/1/2009
Participating Approval Date
6/8/2009
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Oklahoma State University Medical Center
Eric Atkinson, Chief Financial Officer
(918) 599-5147
Primary Contact
Oklahoma State University Medical Center
John Bury, DIRECTOR OF PHARMACY
(918) 599-5565
Addresses
Street Address
744 WEST 9TH STREET
TULSA, OK 74127
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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6/30/2011- DOC. RECD. TO CONFIRM NON-PROFIT STATUS 3/31/10 DOC RECD TO CONFIRM ELIG NON-PROFIT STATUS
07/06/2011
6/30/2011- DOC. RECD. TO CONFIRM NON-PROFIT STATUS 3/31/10 DOC RECD TO CONFIRM ELIG NON-PROFIT STATUS
07/06/2011
May 2025
May 2025
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