Organization
FAIRFAX HEALTHCARE PROPERTIES,LLC
Active
Other names
Fairfax Memorial Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL CHRISTIAN (CEO)
(918) 642-3291
Entity
Organization
Contact information
Practice address
HWY 18 & TAFT AVENUE, FAIRFAX, OK 74637-0219
(918) 642-3291
(918) 642-3694
Mailing address
HWY 18 & TAFT AVENUE, FAIRFAX, OK 74637-0219
(918) 642-3291
(918) 642-3694
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
2274
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000370133001
BCBS OKLAHOMA
OK
05
—
100700710A
—
OK
01
—
F37013301
MEDICARE PART B (LEGACY)
OK
Enumeration date
08/10/2006
Last updated
10/28/2008
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