Healthcare Provider Details

I. General information

NPI: 1700332400
Provider Name (Legal Business Name): SEILING MUNICIPAL HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 09/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N MAIN
PUTNAM OK
73659
US

IV. Provider business mailing address

PO BOX 720
SEILING OK
73663-0720
US

V. Phone/Fax

Practice location:
  • Phone: 580-922-7361
  • Fax:
Mailing address:
  • Phone: 580-922-7361
  • Fax: 580-922-7375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC0050X
TaxonomyCritical Access Hospital Clinic/Center
License Number2256
License Number StateOK

VIII. Authorized Official

Name: JENNIFER COONS
Title or Position: ADMINISTRATOR
Credential:
Phone: 580-922-7361