Healthcare Provider Details

I. General information

NPI: 1396767158
Provider Name (Legal Business Name): LEFLORE COUNTY HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 WALL STREET
POTEAU OK
74953-4405
US

IV. Provider business mailing address

105 WALL ST
POTEAU OK
74953-4433
US

V. Phone/Fax

Practice location:
  • Phone: 918-635-3309
  • Fax: 918-635-3308
Mailing address:
  • Phone: 918-635-3309
  • Fax: 918-635-3308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number37-U040
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number2174
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number370040
License Number StateOK
# 4
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number2174
License Number StateOK

VIII. Authorized Official

Name: TIFFANY B GRIFFIS
Title or Position: CEO
Credential:
Phone: 918-635-3441