Organization
CAH ACQUISITION COMPANY 12 LLC
Active
Parent organization
CAH ACQUISITION COMPANY 12 LLC
Other names
Fairfax Rural Health Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAH ACQUISITION COMPANY 12 LLC
Authorized official
TINA J STEELE (CEO)
(918) 642-3291
Entity
Organization
Contact information
Practice address
40 HOSPITAL RD, FAIRFAX, OK 74637
(918) 642-8827
(918) 642-3298
Mailing address
40 HOSPITAL RD, FAIRFAX, OK 74637-5084
(918) 642-3291
(918) 642-3694
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
2274
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200311270C
—
OK
Enumeration date
03/16/2011
Last updated
07/16/2018
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