1841384062 NPI number — WESTERN HEALTH MANAGEMENT, INC.

Table of content: (NPI 1841384062)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841384062 NPI number — WESTERN HEALTH MANAGEMENT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WESTERN HEALTH MANAGEMENT, INC.
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:
1841384062
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 130
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HYDRO
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73048-0070
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-403-2003
Provider Business Mailing Address Fax Number:
877-505-4114

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 ARAPAHO AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HYDRO
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73048-0070
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-663-2455
Provider Business Practice Location Address Fax Number:
405-663-2443
Provider Enumeration Date:
10/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ABBOTT
Authorized Official First Name:
BARNEY
Authorized Official Middle Name:
KENT
Authorized Official Title or Position:
PRES / OWNER
Authorized Official Telephone Number:
866-403-2003

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  NH06040604 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 314000000X , with the licence number: NH0604-0604 , 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: 200213890A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".




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