# JACKSON COUNTY MEMORIAL HOSPITAL SKILLED NURSING FACILITY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356382899
- **Authorized official:** MR. STEVE HARTGRAVES (PRESIDENT/CEO)
- **Authorized official phone:** (580) 379-5500

## Contact information

- **Practice address:** 1200 E PECAN ST, ALTUS, OK 73521-6141
- **Practice address phone:** (580) 379-5000
- **Practice address fax:** (580) 379-5509
- **Mailing address:** 1200 E PECAN ST, ALTUS, OK 73521-6141
- **Mailing address phone:** (580) 379-5000
- **Mailing address fax:** (580) 379-5509

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 2206 | OK | Yes |

## Other

- **Enumeration date:** 06/08/2006
- **Last updated:** 10/06/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100699350A | — | OK |