Provider Demographics
NPI:1932169950
Name:PAULS VALLEY GENERAL HOSPITAL
Entity Type:Organization
Organization Name:PAULS VALLEY GENERAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE EXEC
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:CHAPMAN
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-238-5501
Mailing Address - Street 1:100 VALLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:PAULS VALLEY
Mailing Address - State:OK
Mailing Address - Zip Code:73075-6613
Mailing Address - Country:US
Mailing Address - Phone:405-238-5501
Mailing Address - Fax:405-238-5926
Practice Address - Street 1:100 VALLEY DRIVE
Practice Address - Street 2:
Practice Address - City:PAULS VALLEY
Practice Address - State:OK
Practice Address - Zip Code:73075
Practice Address - Country:US
Practice Address - Phone:405-238-5501
Practice Address - Fax:405-238-5926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2288282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100699890CMedicaid
OK100699890DMedicaid
OK100699890AMedicaid
OK100699890CMedicaid
OK371572Medicare ID - Type UnspecifiedHOSPICE
OK377249Medicare ID - Type UnspecifiedHOME HEALTH AGENCY
OK37U156Medicare Oscar/Certification
OKP37015601Medicare Oscar/Certification
OK375126Medicare Oscar/Certification