# AHS HENRYETTA HOSPITAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** AHS HILLCREST HEALTHCARE SYSTEM, LLC
- **Other names:** Utica Park Clinic Family Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1871008722
- **Legal business name:** AHS HILLCREST HEALTHCARE SYSTEM, LLC
- **Authorized official:** STEPHEN C. PETROVICH (EVP)
- **Authorized official phone:** (615) 296-3000

## Contact information

- **Practice address:** 2403 W MAIN ST, HENRYETTA, OK 74437
- **Practice address phone:** (918) 652-6950
- **Practice address fax:** (918) 652-7827
- **Mailing address:** 2401 W MAIN ST, HENRYETTA, OK 74437-3893
- **Mailing address phone:** (918) 652-6950
- **Mailing address fax:** (918) 652-7827

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/13/2017
- **Last updated:** 06/04/2019