Healthcare Provider Details

I. General information

NPI: 1932169950
Provider Name (Legal Business Name): PAULS VALLEY GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 07/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 VALLEY DRIVE
PAULS VALLEY OK
73075
US

IV. Provider business mailing address

100 VALLEY DRIVE
PAULS VALLEY OK
73075-6613
US

V. Phone/Fax

Practice location:
  • Phone: 405-238-5501
  • Fax: 405-238-5926
Mailing address:
  • Phone: 405-238-5501
  • Fax: 405-238-5926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number2288
License Number StateOK

VIII. Authorized Official

Name: PATRICIA CHAPMAN WEAVER
Title or Position: BUSINESS OFFICE EXEC
Credential:
Phone: 405-238-5501