Provider Demographics
NPI:1134123193
Name:ST. ANTHONY SHAWNEE HOSPITAL, INC.
Entity type:Organization
Organization Name:ST. ANTHONY SHAWNEE HOSPITAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:EDMOND
Authorized Official - Last Name:SKILLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-878-8110
Mailing Address - Street 1:1102 W MACARTHUR
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-1743
Mailing Address - Country:US
Mailing Address - Phone:405-878-8110
Mailing Address - Fax:405-878-8101
Practice Address - Street 1:1102 W MACARTHUR
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804
Practice Address - Country:US
Practice Address - Phone:405-878-8110
Practice Address - Fax:405-878-8101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-08
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2162282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100740840AMedicaid
OK000370149001OtherBCBS
OK100740840HMedicaid
OK100740840BMedicaid
OK100740840HMedicaid
OK100740840AMedicaid
OK800522341Medicare PIN