Provider Demographics
NPI:1598938722
Name:HARMON COUNTY HEALTHCARE AUTHORITY
Entity Type:Organization
Organization Name:HARMON COUNTY HEALTHCARE AUTHORITY
Other - Org Name:HARMON MEDICAL CLINC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERIDEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-688-3363
Mailing Address - Street 1:502 E CHESTNUT ST
Mailing Address - Street 2:P.O. BOX 791
Mailing Address - City:HOLLIS
Mailing Address - State:OK
Mailing Address - Zip Code:73550-2032
Mailing Address - Country:US
Mailing Address - Phone:580-688-2800
Mailing Address - Fax:580-688-2193
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:580-688-2800
Practice Address - Fax:580-688-2193
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARMON COUNTY HEALTHCARE AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center