Organization
AHS HENRYETTA HOSPITAL LLC
Active
Parent organization
AHS HILLCREST HEALTHCARE SYSTEM, LLC
Other names
Utica Park Clinic Primary Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
AHS HILLCREST HEALTHCARE SYSTEM, LLC
Authorized official
STEPHEN C. PETROVICH (EVP)
(615) 296-3000
Entity
Organization
Contact information
Practice address
2405 W MAIN ST STE A, HENRYETTA, OK 74437
(918) 650-1180
(918) 650-1294
Mailing address
2405 W MAIN ST, HENRYETTA, OK 74437-3893
(918) 650-1180
(918) 650-1294
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/12/2018
Last updated
05/29/2019
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