Healthcare Provider Details

I. General information

NPI: 1497857437
Provider Name (Legal Business Name): ROGER MILLS COUNTY HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 12/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S LL MALES AVE
CHEYENNE OK
73628-0219
US

IV. Provider business mailing address

PO BOX 219
CHEYENNE OK
73628-0219
US

V. Phone/Fax

Practice location:
  • Phone: 580-497-3336
  • Fax: 580-497-2124
Mailing address:
  • Phone: 580-497-3336
  • Fax: 580-497-2124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number2209
License Number StateOK

VIII. Authorized Official

Name: CYNTHIA ELLEN DUNCAN
Title or Position: CEO
Credential:
Phone: 580-497-3336