| Jackson County Memorial Hospital Authority | |
|
114 S Louis Tittle Ave Mangum OK 73554-4406 | |
| (580) 782-3393 | |
| (580) 782-3395 |
| Full Name | Jackson County Memorial Hospital Authority |
|---|---|
| Speciality | Clinic/Center |
| Location | 114 S Louis Tittle Ave, Mangum, Oklahoma |
| Authorized Official Name and Position | Steve Hartgraves (PRESIDENT / CEO) |
| Authorized Official Contact | 5803795500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson County Memorial Hospital Authority 1200 E Pecan St Altus OK 73521-6141 Ph: (580) 379-5000 | Jackson County Memorial Hospital Authority 114 S Louis Tittle Ave Mangum OK 73554-4406 Ph: (580) 782-3393 |
| NPI Number | 1093199382 |
|---|---|
| Provider Enumeration Date | 07/16/2015 |
| Last Update Date | 10/06/2022 |
| Medicare PECOS PAC ID | 1759293178 |
|---|---|
| Medicare Enrollment ID | O20150922001829 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093199382 | NPI | - | NPPES |
| 200688770A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Blackhawk Mangum, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 118 South Louis Tittle, Mangum, OK 73554 Phone: 580-782-2113 Fax: 580-782-2141 | |
Blackhawk Mangum Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: One Wickersham Drive, Mangum, OK 73554 Phone: 580-782-3353 | |
Blackhawk Mangum Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 118 S Louis Tittle Ave, Mangum, OK 73554 Phone: 580-782-3353 | |
Blackhawk Mangum, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Wickersham St, Mangum, OK 73554 Phone: 580-782-3353 | |
Mangum City Hospital Authority Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 118 S Louis Tittle Ave, Mangum, OK 73554 Phone: 580-782-2000 Fax: 580-782-5906 | |
Tlc Of Chiropractic L.l.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 314 W Lincoln St, Mangum, OK 73554 Phone: 580-782-3141 |