# W W HASTINGS INDIAN HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** W W HASTINGS INDIAN HOSPITAL
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1629235452
- **Legal business name:** W W HASTINGS INDIAN HOSPITAL
- **Authorized official:** MR. EDWIN L MCLEMORE (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (918) 458-3100

## Contact information

- **Practice address:** 100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
- **Practice address phone:** (918) 458-3100
- **Practice address fax:** (918) 458-3628
- **Mailing address:** PO BOX 676967, DALLAS, TX 75267-6967
- **Mailing address phone:** (918) 458-3100
- **Mailing address fax:** (918) 458-3628

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/20/2008
- **Last updated:** 01/21/2009