Healthcare Provider Details

I. General information

NPI: 1053381947
Provider Name (Legal Business Name): SMH ACQUISITION,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 05/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 HOSPITAL DR
SAYRE OK
73662-1206
US

IV. Provider business mailing address

911 HOSPITAL DR
SAYRE OK
73662-1206
US

V. Phone/Fax

Practice location:
  • Phone: 580-323-9692
  • Fax: 580-323-9820
Mailing address:
  • Phone: 580-323-9692
  • Fax: 580-323-9820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number2207
License Number StateOK

VIII. Authorized Official

Name: MR. ROBERT HICKS
Title or Position: MANAGING MEMBER
Credential:
Phone: 405-821-0435