Healthcare Provider Details
I. General information
NPI: 1972878767
Provider Name (Legal Business Name): CAH ACQUISITION COMPANY 9 LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/13/2012
Last Update Date: 03/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
US HIGHWAY 60 NORTHEAST
SEILING OK
73663-0000
US
IV. Provider business mailing address
PO BOX 720
SEILING OK
73663-0720
US
V. Phone/Fax
- Phone: 580-922-7361
- Fax: 580-922-7718
- Phone: 580-922-7361
- Fax: 580-922-7718
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LARRY
G
TROXELL
Title or Position: CEO
Credential:
Phone: 580-922-7361