Healthcare Provider Details

I. General information

NPI: 1144534603
Provider Name (Legal Business Name): ALVA HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2010
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 SHARE DR STE 100
ALVA OK
73717-3614
US

IV. Provider business mailing address

800 SHARE DR PO BOX 727
ALVA OK
73717-3618
US

V. Phone/Fax

Practice location:
  • Phone: 580-430-3366
  • Fax: 580-430-3374
Mailing address:
  • Phone: 580-327-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC0050X
TaxonomyCritical Access Hospital Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KANDICE ALLEN
Title or Position: CEO
Credential:
Phone: 580-327-2800