Healthcare Provider Details

I. General information

NPI: 1376790147
Provider Name (Legal Business Name): MERCY HOSPITAL HEALDTON, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2008
Last Update Date: 09/23/2021
Certification Date: 09/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3462 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: 580-229-0701
  • Fax:
Mailing address:
  • Phone: 417-820-7133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State

VIII. Authorized Official

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