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NPI Code Detail

MEDICARE: REYNOLDS ARMY COMMUNITY HOSPITAL

MEDICARE: REYNOLDS ARMY COMMUNITY HOSPITAL
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
1261QM1100XMilitary/U.S. Coast Guard Outpatient Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11487752960OTHERPARENT FACILITY NPI 2

General Provider Information

NPI Number : 1821318668
Entity Type Code : Organization
Provider Name (Legal Business Name) : REYNOLDS ARMY COMMUNITY HOSPITAL
Provider Business Mailing Address
First Line : 3009 NW WILSON STREET
Second Line : ATTN MCUA-PAD-PF - BILLING OFFICE
City : FORT SILL
State : OK
Zip : 73503
Country : US
Telephone Number : 580-458-2793
Fax Number :
Provider Business Practice Location Address
First Line : 5404 SW LEE BLVD
Second Line : FRONTIER MEDICAL HOME-SILL
City : LAWTON
State : OK
Zip : 73505-9695
Country : US
Telephone Number : 580-558-2800
Fax Number :
Authorized Official
Title or Position : UBO MANAGER
Name : CHARLES CHITTUM
Credential :
Telephone Number : 580-558-2793
Provider Enumeration Date : 06/03/2010
Last Update Date : 02/26/2014

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Directions to “REYNOLDS ARMY COMMUNITY HOSPITAL ” Practice Location

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