Provider Demographics
NPI:1689922098
Name:CAH ACQUISITION COMPANY 4 INC
Entity Type:Organization
Organization Name:CAH ACQUISITION COMPANY 4 INC
Other - Org Name:DRUMRIGHT REGIONAL HOSPITAL PROFESSIONAL GROUP
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 1:610 W BYPASS
Practice Address - Street 2:SUITE B
Practice Address - City:DRUMRIGHT
Practice Address - State:OK
Practice Address - Zip Code:74030
Practice Address - Country:US
Practice Address - Phone:918-382-2300
Practice Address - Fax:918-382-2391
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAH ACQUISITION COMPANY 4 INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-16
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2367207P00000X, 207P00000X, 207R00000X, 208M00000X, 363A00000X, 363L00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200259440EMedicaid
OKOKA104873Medicare Oscar/Certification