Provider Demographics
NPI:1558314898
Name:WOODWARD HEALTH SYSTEM LLC
Entity Type:Organization
Organization Name:WOODWARD HEALTH SYSTEM LLC
Other - Org Name:ALLIANCEHEALTH WOODWARD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, BUSINESS OFFICE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7466
Mailing Address - Street 1:PO BOX 849110
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75286-0001
Mailing Address - Country:US
Mailing Address - Phone:580-256-5511
Mailing Address - Fax:580-254-8418
Practice Address - Street 1:900 17TH ST
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-2448
Practice Address - Country:US
Practice Address - Phone:580-256-5511
Practice Address - Fax:580-254-8418
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOODWARD HEALTH SYSTEM LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-18
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2252273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
37S002Medicare Oscar/Certification