Healthcare Provider Details

I. General information

NPI: 1295836922
Provider Name (Legal Business Name): MERCY HOSPITAL ARDMORE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 12TH AVE NW
ARDMORE OK
73401-5712
US

IV. Provider business mailing address

1011 14TH AVE NW
ARDMORE OK
73401-1828
US

V. Phone/Fax

Practice location:
  • Phone: 580-220-6600
  • Fax: 580-220-6375
Mailing address:
  • Phone: 805-223-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: TAMMI HARMONING
Title or Position: CFO
Credential:
Phone: 580-223-6239