1356529622 NPI number — HASKELL COUNTY-CITY OF STIGLER HOSPITAL AUTHORITY

Table of content: (NPI 1356529622)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356529622 NPI number — HASKELL COUNTY-CITY OF STIGLER HOSPITAL AUTHORITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HASKELL COUNTY-CITY OF STIGLER HOSPITAL AUTHORITY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HASKELL COUNTY HEALTHCARE SYSTEM
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356529622
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/01/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 728
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STIGLER
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74462-0728
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-967-4682
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 NW H ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STIGLER
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74462-1625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-967-4682
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/08/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MORRIS
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
S
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
918-967-4682

Provider Taxonomy Codes

  • Taxonomy code: 275N00000X , with the licence number:  275N00000X , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100700850 , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".