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General NPI Number Information
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NPI Number | 1053353631
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Entity Type | Organization
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Legal Business Name | LATIMER COUNTY HOSPITAL AUTHORITY
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 07/09/2018
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Provider Practice Location Address
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Address Line | 806 HIGHWAY 2 N
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City | WILBURTON
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State | OK
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Zip | 74578-3625
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Country | US
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Telephone | 918-465-2391
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Fax | 918-465-9350
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Provider Business Mailing Address
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Address Line | 806 HIGHWAY 2 NORTH
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City | WILBURTON
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State | OK
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Zip | 74578-3625
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Country | US
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Telephone | 918-465-2391
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Fax | 918-465-9350
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Authorized Official
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Title or Position | CEO
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Name | MRS. SUSAN NIX
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Credential | MSN, RN
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Telephone | 918-465-2391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | 2204
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License Number State | OK
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