Provider Demographics
NPI:1700821642
Name:MCALESTER REGIONAL HEALTH CENTER AUTHORITY
Entity Type:Organization
Organization Name:MCALESTER REGIONAL HEALTH CENTER AUTHORITY
Other - Org Name:MCALESTER REGIONAL HOME MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP HR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:E
Authorized Official - Last Name:MOUSER
Authorized Official - Suffix:
Authorized Official - Credentials:VP HR
Authorized Official - Phone:918-421-8060
Mailing Address - Street 1:1101 N. STRONG BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-4263
Mailing Address - Country:US
Mailing Address - Phone:918-421-6680
Mailing Address - Fax:918-421-6684
Practice Address - Street 1:1101 N. STRONG BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-4263
Practice Address - Country:US
Practice Address - Phone:918-421-6680
Practice Address - Fax:918-421-6684
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCALESTER REGIONAL HEALTH CENTER AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-17
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2203332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100700070BMedicaid
OK100700070AMedicaid
OK4235930001Medicare NSC