Jcmh Pediatric Clinic

LBN: Jackson County Memorial Hospital Authority
Jcmh Pediatric Clinic is an health care organization with primary practice located at 101 S Park Ln Suite 100, Altus OK 73521-5731. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rural Health, which is considered as the primary health care specialty. Jackson County Memorial Hospital Authority can be contacted via phone (580) 379-6100, or through Hartgraves, Steve via phone (580) 379-5500.

Contact Information

Primary practice address
101 S Park Ln Suite 100 Altus OK 73521-5731
Phone: (580) 379-6100
Fax: (580) 379-6109
Website:
Map and Directions
Authorized official contact:
Name: Hartgraves, Steve
Phone: (580) 379-5500

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X

Profile Details

NPI number 1407230790
LBN Legal business name Jackson County Memorial Hospital Authority
DBA Doing business as Jcmh Pediatric Clinic
Authorized official Hartgraves, Steve
Entity Organization
Organization subpart 1 No
Enumeration date Jul 16th, 2015
Last updated Oct 6th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407230790 NPPES
Oklahoma MEDICAID 200688750A

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