Healthcare Provider Details

I. General information

NPI: 1598938722
Provider Name (Legal Business Name): HARMON COUNTY HEALTHCARE AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2008
Last Update Date: 04/09/2008
Certification Date:
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 P.O. BOX 791
HOLLIS OK
73550-2032
US

V. Phone/Fax

Practice location:
  • Phone: 580-688-2800
  • Fax: 580-688-2193
Mailing address:
  • Phone: 580-688-2800
  • Fax: 580-688-2193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHERIDEEN THOMAS
Title or Position: OFFICE MANAGER
Credential:
Phone: 580-688-3363