Provider Demographics
NPI:1235663196
Name:SMH ACQUISITION LLC
Entity Type:Organization
Organization Name:SMH ACQUISITION LLC
Other - Org Name:SAYRE COMMUNITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LANDON
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:HISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-323-9698
Mailing Address - Street 1:911 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:SAYRE
Mailing Address - State:OK
Mailing Address - Zip Code:73662-1206
Mailing Address - Country:US
Mailing Address - Phone:580-323-9698
Mailing Address - Fax:580-323-9820
Practice Address - Street 1:911 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:OK
Practice Address - Zip Code:73662-1206
Practice Address - Country:US
Practice Address - Phone:580-323-9698
Practice Address - Fax:580-323-9820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2207282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100700160AMedicaid
OK100700160AMedicaid