Healthcare Provider Details

I. General information

NPI: 1679684682
Provider Name (Legal Business Name): ALVA HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date: 02/25/2020
Reactivation Date: 02/28/2020

III. Provider practice location address

800 SHARE DR
ALVA OK
73717-3618
US

IV. Provider business mailing address

800 SHARE DR
ALVA OK
73717-3613
US

V. Phone/Fax

Practice location:
  • Phone: 580-327-2800
  • Fax: 580-430-3332
Mailing address:
  • Phone: 580-327-2800
  • Fax: 580-430-3374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number2251
License Number StateOK

VIII. Authorized Official

Name: KANDICE ALLEN
Title or Position: CEO
Credential:
Phone: 580-430-3309