# JACKSON COUNTY MEMORIAL HOSPITAL AUTHORITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** JCMH Family Care Medical Clinic, JCMH FAMILYCARE MEDICAL CLINIC OF MANGUM
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093199382
- **Authorized official:** MR. STEVE HARTGRAVES (PRESIDENT / CEO)
- **Authorized official phone:** (580) 379-5500

## Contact information

- **Practice address:** 114 S LOUIS TITTLE AVE, MANGUM, OK 73554-4406
- **Practice address phone:** (580) 782-3393
- **Practice address fax:** (580) 782-3395
- **Mailing address:** 1200 E PECAN ST, ALTUS, OK 73521-6141
- **Mailing address phone:** (580) 379-5000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/16/2015
- **Last updated:** 10/06/2022