Healthcare Provider Details

I. General information

NPI: 1437467388
Provider Name (Legal Business Name): MERCY HOSPITAL HEALDTON, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2010
Last Update Date: 09/23/2021
Certification Date: 09/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3472 HOSPITAL RD
HEALDTON OK
73438-6124
US

IV. Provider business mailing address

3462 HOSPITAL RD
HEALDTON OK
73438-6124
US

V. Phone/Fax

Practice location:
  • Phone: 580-229-0079
  • Fax: 580-229-9982
Mailing address:
  • Phone: 417-820-7133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHERRY LYNN CLOUSE DAY
Title or Position: VP FINANCE
Credential:
Phone: 417-820-8439