1972780252 NPI number — PURCELL MUNICIPAL 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 1972780252 NPI number — PURCELL MUNICIPAL HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PURCELL MUNICIPAL 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:
MAYSVILLE MEDICAL CENTER
Provider Other Organization Name Type Code:
3
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:
1972780252
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 660
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAYSVILLE
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73057-0660
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-867-4404
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
504 WILLIAMS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAYSVILLE
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-867-4404
Provider Business Practice Location Address Fax Number:
405-867-4520
Provider Enumeration Date:
01/29/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LEE
Authorized Official First Name:
KATHY
Authorized Official Middle Name:
L
Authorized Official Title or Position:
BUSINESS OFFICE MANAGER
Authorized Official Telephone Number:
405-527-2216

Provider Taxonomy Codes

  • Taxonomy code: 282NR1301X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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