Healthcare Provider Details

I. General information

NPI: 1992821326
Provider Name (Legal Business Name): AHS PAWNEE HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 4TH ST
PAWNEE OK
74058-4046
US

IV. Provider business mailing address

1212 4TH ST
PAWNEE OK
74058-4046
US

V. Phone/Fax

Practice location:
  • Phone: 918-762-2577
  • Fax: 918-392-1995
Mailing address:
  • Phone: 918-762-2577
  • Fax: 918-392-1995

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: TERESA M HESKETT
Title or Position: MEDICAL RECORDS DIRECTOR
Credential:
Phone: 918-762-6369