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General NPI Number Information
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NPI Number | 1508896499
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Entity Type | Organization
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Legal Business Name | ATOKA COUNTY HEALTHCARE AUTHORITY
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 01/27/2009
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Provider Practice Location Address
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Address Line | 1200 WEST LIBERTY ROAD
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City | ATOKA
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State | OK
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Zip | 74525-1621
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Country | US
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Telephone | 580-889-3333
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Fax | 580-889-4225
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Provider Business Mailing Address
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Address Line | 1200 WEST LIBERTY ROAD
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City | ATOKA
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State | OK
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Zip | 74525-1621
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Country | US
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Telephone | 580-889-3333
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Fax | 580-889-4225
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Authorized Official
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Title or Position | CEO
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Name | MR. CHARLES E. YOUNG
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Credential | MS
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Telephone | 580-889-3333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 2205
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License Number State | OK
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