Provider Demographics
NPI:1700138336
Name:HARMON COUNTY HEALTHCARE AUTHORITY
Entity Type:Organization
Organization Name:HARMON COUNTY HEALTHCARE AUTHORITY
Other - Org Name:HARMON MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-688-3363
Mailing Address - Street 1:PO BOX 791
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:OK
Mailing Address - Zip Code:73550-0791
Mailing Address - Country:US
Mailing Address - Phone:580-688-3363
Mailing Address - Fax:580-688-9730
Practice Address - Street 1:400 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:OK
Practice Address - Zip Code:73550-2030
Practice Address - Country:US
Practice Address - Phone:580-688-3363
Practice Address - Fax:580-688-9730
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARMON COUNTY HEALTHCARE AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-05
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2211261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty