Provider Demographics
NPI:1477138352
Name:ALVA HOSPITAL AUTHORITY/DBA SHARE MEDICAL CENTER
Entity Type:Organization
Organization Name:ALVA HOSPITAL AUTHORITY/DBA SHARE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-430-3309
Mailing Address - Street 1:800 SHARE DR
Mailing Address - Street 2:
Mailing Address - City:ALVA
Mailing Address - State:OK
Mailing Address - Zip Code:73717-3618
Mailing Address - Country:US
Mailing Address - Phone:580-327-2800
Mailing Address - Fax:
Practice Address - Street 1:957 EAGLE PASS
Practice Address - Street 2:
Practice Address - City:FREEDOM
Practice Address - State:OK
Practice Address - Zip Code:73842
Practice Address - Country:US
Practice Address - Phone:580-430-3333
Practice Address - Fax:580-430-3305
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALVA HOSPITAL AUTHORITY/DBA SHARE MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center