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General NPI Number Information
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NPI Number | 1083286975
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Entity Type | Organization
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Legal Business Name | SHORTGRASS COMMUNITY HEALTH CENTER, INC
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Dates
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Enumeration Date | 07/12/2021
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Last Update Date | 07/12/2021
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Provider Practice Location Address
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Address Line | 400 E SYCAMORE ST
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City | HOLLIS
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State | OK
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Zip | 73550-1436
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Country | US
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Telephone | 580-688-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 400 E SYCAMORE ST
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City | HOLLIS
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State | OK
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Zip | 73550-1436
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Country | US
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Telephone | 580-688-2800
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JANET LYNN TIPTON
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Credential |
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Telephone | 580-688-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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