Provider Demographics
NPI:1831383496
Name:FARMERS UNION HOSPITAL ASSOCIATION
Entity type:Organization
Organization Name:FARMERS UNION HOSPITAL ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VALORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TIBBETTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-821-5505
Mailing Address - Street 1:PO BOX 2339
Mailing Address - Street 2:1801 W 3RD STREET
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73648-2339
Mailing Address - Country:US
Mailing Address - Phone:580-821-5505
Mailing Address - Fax:
Practice Address - Street 1:825 SOONER DRIVE
Practice Address - Street 2:
Practice Address - City:BURNS FLAT
Practice Address - State:OK
Practice Address - Zip Code:73624
Practice Address - Country:US
Practice Address - Phone:580-821-5505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
800522263OtherMEDICARE GRP#