Provider Demographics
NPI:1477609337
Name:PAWNEE MUNICIPAL HOPSITAL
Entity Type:Organization
Organization Name:PAWNEE MUNICIPAL HOPSITAL
Other - Org Name:CARING HANDS HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:R.N., HOSPICE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MULDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-762-3629
Mailing Address - Street 1:1212 4TH ST
Mailing Address - Street 2:
Mailing Address - City:PAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74058-4046
Mailing Address - Country:US
Mailing Address - Phone:918-762-3629
Mailing Address - Fax:918-762-6376
Practice Address - Street 1:1212 4TH ST
Practice Address - Street 2:
Practice Address - City:PAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74058-4046
Practice Address - Country:US
Practice Address - Phone:918-762-3629
Practice Address - Fax:918-762-6376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4096251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK371565Medicare ID - Type UnspecifiedPROVIDER NUMBER