Provider Demographics
NPI:1912170309
Name:KIOWA COUNTY HOSPITAL AUTHORITY
Entity type:Organization
Organization Name:KIOWA COUNTY HOSPITAL AUTHORITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:FINCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-726-3324
Mailing Address - Street 1:429 W ELM ST
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:OK
Mailing Address - Zip Code:73651-1615
Mailing Address - Country:US
Mailing Address - Phone:580-726-3324
Mailing Address - Fax:580-726-6041
Practice Address - Street 1:429 W ELM ST
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:OK
Practice Address - Zip Code:73651-1615
Practice Address - Country:US
Practice Address - Phone:580-726-3324
Practice Address - Fax:580-726-6041
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KIOWA COUNTY HOSPITAL AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2212275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK37U153Medicare PIN