Provider Demographics
NPI:1659600815
Name:CAH ACQUISITION COMPANY 4 INC
Entity Type:Organization
Organization Name:CAH ACQUISITION COMPANY 4 INC
Other - Org Name:DRUMRIGHT RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:CAPSHEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-382-2300
Mailing Address - Street 1:610 W BYPASS
Mailing Address - Street 2:
Mailing Address - City:DRUMRIGHT
Mailing Address - State:OK
Mailing Address - Zip Code:74030-5957
Mailing Address - Country:US
Mailing Address - Phone:918-382-2300
Mailing Address - Fax:918-382-2391
Practice Address - Street 1:612 W. BYPASS
Practice Address - Street 2:
Practice Address - City:DRUMRIGHT
Practice Address - State:OK
Practice Address - Zip Code:74030
Practice Address - Country:US
Practice Address - Phone:918-382-5955
Practice Address - Fax:918-382-4709
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAH ACQUISITION COMPANY 4 INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-17
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2367261QR1300X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200259440DMedicaid
OK373464Medicare Oscar/Certification