Healthcare Provider Details

I. General information

NPI: 1417991142
Provider Name (Legal Business Name): HARMON COUNTY HEALTHCARE AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 04/21/2022
Certification Date: 04/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 E CHESTNUT ST
HOLLIS OK
73550-2032
US

IV. Provider business mailing address

502 E CHESTNUT ST PO BOX 663
HOLLIS OK
73550-2032
US

V. Phone/Fax

Practice location:
  • Phone: 580-688-3353
  • Fax:
Mailing address:
  • Phone: 580-688-3353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KRYSTAL THOMASON
Title or Position: ADMINISTRATOR
Credential:
Phone: 580-688-3353