Provider Demographics
NPI:1417991142
Name:HARMON COUNTY HEALTHCARE AUTHORITY
Entity Type:Organization
Organization Name:HARMON COUNTY HEALTHCARE AUTHORITY
Other - Org Name:HARMON COUNTY HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-688-3353
Mailing Address - Street 1:502 E CHESTNUT ST
Mailing Address - Street 2:PO BOX 663
Mailing Address - City:HOLLIS
Mailing Address - State:OK
Mailing Address - Zip Code:73550-2032
Mailing Address - Country:US
Mailing Address - Phone:580-688-3353
Mailing Address - Fax:
Practice Address - Street 1:502 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:OK
Practice Address - Zip Code:73550-2032
Practice Address - Country:US
Practice Address - Phone:580-688-3353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK377472Medicare Oscar/Certification