Provider Demographics
NPI:1497857437
Name:ROGER MILLS COUNTY HOSPITAL AUTHORITY
Entity type:Organization
Organization Name:ROGER MILLS COUNTY HOSPITAL AUTHORITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-497-3336
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:OK
Mailing Address - Zip Code:73628-0219
Mailing Address - Country:US
Mailing Address - Phone:580-497-3336
Mailing Address - Fax:580-497-2124
Practice Address - Street 1:501 S LL MALES AVE
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:OK
Practice Address - Zip Code:73628-0219
Practice Address - Country:US
Practice Address - Phone:580-497-3336
Practice Address - Fax:580-497-2124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2209282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK000370131001OtherBCBS
OK100699820AMedicaid
OK100699820AMedicaid
OK37Z303Medicare Oscar/Certification
OK000370131001OtherBCBS