| Beaver County Memorial Hospital | |
|
718 Ave. A Beaver OK 73932-3101 | |
| (580) 625-3477 | |
| (580) 625-3562 |
| Full Name | Beaver County Memorial Hospital |
|---|---|
| Speciality | Clinic/Center |
| Location | 718 Ave. A, Beaver, Oklahoma |
| Authorized Official Name and Position | Brent Meyers (ADMINISTRATOR) |
| Authorized Official Contact | 5806254551 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beaver County Memorial Hospital Po Box 640 Beaver OK 73932-0640 Ph: (580) 625-3477 | Beaver County Memorial Hospital 718 Ave. A Beaver OK 73932-3101 Ph: (580) 625-3477 |
| NPI Number | 1487631156 |
|---|---|
| Provider Enumeration Date | 12/23/2005 |
| Last Update Date | 04/15/2010 |
| Medicare PECOS PAC ID | 9335134246 |
|---|---|
| Medicare Enrollment ID | O20040419001694 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487631156 | NPI | - | NPPES |
| 100700760F | Medicaid | OK | |
| 100700760H | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2242 (Oklahoma) | Primary |
| Provider Name | Susan Danielle Trippet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346367711 PECOS PAC ID: 7618004375 Enrollment ID: I20100428000946 |
| Provider Name | Aaron S Sizelove |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053547950 PECOS PAC ID: 7618131160 Enrollment ID: I20120612000659 |
| Provider Name | Lynnetta Faye Stout |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609027036 PECOS PAC ID: 2668604489 Enrollment ID: I20140410000071 |
| Provider Name | Jennifer Jo Sparks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780041384 PECOS PAC ID: 1153713417 Enrollment ID: I20220118001152 |
| Provider Name | Scotty King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750024741 PECOS PAC ID: 9830579408 Enrollment ID: I20220629002714 |
Woodward Health System Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 623 Avenue C, Beaver, OK 73932 Phone: 580-625-2273 Fax: 580-625-2274 | |
Woodward Health System Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 623 Avenue C, Beaver, OK 73932 Phone: 580-625-2273 Fax: 580-625-2274 |