1821318668 NPI number — REYNOLDS ARMY COMMUNITY HOSPITAL

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821318668 NPI number — REYNOLDS ARMY COMMUNITY HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REYNOLDS ARMY COMMUNITY HOSPITAL
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:
Provider Other Organization Name Type Code:
6
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:
1821318668
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3009 NW WILSON STREET
Provider Second Line Business Mailing Address:
ATTN MCUA-PAD-PF - BILLING OFFICE
Provider Business Mailing Address City Name:
FORT SILL
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73503
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
580-458-2793
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5404 SW LEE BLVD
Provider Second Line Business Practice Location Address:
FRONTIER MEDICAL HOME-SILL
Provider Business Practice Location Address City Name:
LAWTON
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73505-9695
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-558-2800
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/03/2010

Additional Information

Authorized Official

Authorized Official Last Name:
CHITTUM
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
Authorized Official Title or Position:
UBO MANAGER
Authorized Official Telephone Number:
580-558-2793

Provider Taxonomy Codes

  • Taxonomy code: 261QM1100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1487752960 . This is a "PARENT FACILITY NPI 2" identifier . This identifiers is of the category "OTHER".




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