Provider Demographics
NPI:1396988903
Name:CAH ACQUISITION COMPANY 4 INC
Entity type:Organization
Organization Name:CAH ACQUISITION COMPANY 4 INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
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:
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?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-13
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2367275N00000X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200259440AMedicaid
OK37Z331Medicare Oscar/Certification
OK371331Medicare Oscar/Certification