Organization
BEAVER COUNTY MEMORIAL HOSPITAL
Active
Other names
Community Clinic of Beaver
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENT MEYERS (ADMINISTRATOR)
(580) 625-4551
Entity
Organization
Contact information
Practice address
718 AVE. A, BEAVER, OK 73932-3101
(580) 625-3477
(580) 625-3562
Mailing address
PO BOX 640, BEAVER, OK 73932-0640
(580) 625-3477
(580) 625-3562
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
2242
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100700760F
—
OK
05
—
100700760H
—
OK
Enumeration date
12/23/2005
Last updated
04/15/2010
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