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Organization
COUNTY OF TILLMAN - CITY OF FREDERICK HOSPITAL AUTHORITY
Active
Organization
COUNTY OF TILLMAN - CITY OF FREDERICK HOSPITAL AUTHORITY
Active
Parent organization
COUNTY OF TILLMAN-CITY OF FRE
Other names
Memorial Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF TILLMAN-CITY OF FRE
Authorized official
MR. RYAN D. ADE PT (BOARD CHAIRMAN)
(580) 335-6642
Entity
Organization
Contact information
Practice address
319 E JOSEPHINE AVENUE, FREDERICK, OK 73542-2220
(580) 335-6600
(580) 335-5044
Mailing address
319 E JOSEPHINE AVENUE, FREDERICK, OK 73542-2220
(580) 335-6600
(580) 335-5044
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
7103
OK
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10076110B
—
OK
05
—
100776110B
—
OK
Enumeration date
12/27/2005
Last updated
06/20/2023
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