MEDICARE: WOODWARD HEALTH SYSTEM LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center		OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730434424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODWARD HEALTH SYSTEM LLC

Provider Business Mailing Address
First Line	:	900 17TH ST
Second Line	:
City	:	WOODWARD
State	:	OK
Zip	:	73801-2448
Country	:	US
Telephone Number	:	580-256-5511
Fax Number	:

Provider Business Practice Location Address
First Line	:	1818 KANSAS AVE
Second Line	:
City	:	WOODWARD
State	:	OK
Zip	:	73801-2912
Country	:	US
Telephone Number	:	580-254-3396
Fax Number	:	580-254-5311

Authorized Official
Title or Position	:	DIRECTOR/DELEGATED OFFICIAL
Name	:	PAULA LALOR
Credential	:
Telephone Number	:	629-215-3953

Provider Enumeration Date	:	07/18/2012
Last Update Date	:	04/26/2021

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Directions to “WOODWARD HEALTH SYSTEM LLC ” Practice Location

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