Healthcare Provider Details

I. General information

NPI: 1114421492
Provider Name (Legal Business Name): FARMERS UNION HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2018
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 W 1ST ST SUITES 101, 102, 103 AND 105
ELK CITY OK
73644-3133
US

IV. Provider business mailing address

PO BOX 2339
ELK CITY OK
73648-2339
US

V. Phone/Fax

Practice location:
  • Phone: 580-225-2515
  • Fax: 580-303-5850
Mailing address:
  • Phone: 580-225-2511
  • Fax: 580-225-9143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: COREY LIVELY
Title or Position: CEO
Credential:
Phone: 580-821-5300