Organization
JACKSON COUNTY MEMORIAL HOSPITAL AUTHORITY
Active
Other names
JCMH Family Care Medical Clinic, JCMH FAMILYCARE MEDICAL CLINIC OF MANGUM
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVE HARTGRAVES (PRESIDENT / CEO)
(580) 379-5500
Entity
Organization
Contact information
Practice address
114 S LOUIS TITTLE AVE, MANGUM, OK 73554-4406
(580) 782-3393
(580) 782-3395
Mailing address
1200 E PECAN ST, ALTUS, OK 73521-6141
(580) 379-5000
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200688770A
—
OK
Enumeration date
07/16/2015
Last updated
10/06/2022
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