Organization
BLACKWELL HMA LLC
Active
Organization
BLACKWELL HMA LLC
Active
Parent organization
BLACKWELL HMA LLC
Other names
AllianceHealth Blackwell
Organization subpart
Yes
Provider details
NPI number
Legal business name
BLACKWELL HMA LLC
Authorized official
LAURIE HOLTSFORD (AUTHORIZED OFFICIAL)
(615) 465-7466
Entity
Organization
Contact information
Practice address
710 S 13TH ST, BLACKWELL, OK 74631-3700
(580) 363-2311
Mailing address
710 S 13TH ST, BLACKWELL, OK 74631-3700
(580) 363-2311
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
2281
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100700340A
—
OK
05
—
100700340C
—
OK
Enumeration date
08/17/2006
Last updated
07/23/2015
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