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General NPI Number Information
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NPI Number | 1609874759
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Entity Type | Organization
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Legal Business Name | LOGAN HOSPITAL AND MEDICAL CENTER AUTHORITY
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 200 S ACADEMY RD
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City | GUTHRIE
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State | OK
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Zip | 73044-8727
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Country | US
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Telephone | 405-282-9406
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Fax | 405-282-9404
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Provider Business Mailing Address
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Address Line | PO BOX 1017
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City | GUTHRIE
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State | OK
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Zip | 73044-1017
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Country | US
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Telephone | 405-282-9406
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Fax | 405-282-9404
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Authorized Official
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Title or Position | CEO
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Name | MARY J MESSELT
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Credential |
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Telephone | 405-260-4191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 7251
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License Number State | OK
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