Organization
MAYES COUNTY HMA, LLC
Active
Other names
AllianceHealth Pryor
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE HOLTSFORD (AUTHORIZED OFFICIAL)
(615) 465-7466
Entity
Organization
Contact information
Practice address
111 N BAILEY ST, PRYOR, OK 74361-4201
(918) 825-1600
Mailing address
111 N BAILEY ST, PRYOR, OK 74361-4201
(918) 825-1600
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
2183
OK
282N00000X
General Acute Care Hospital
Primary
2183
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100096890A
—
OK
05
—
100118840A
—
OK
05
—
100133830B
—
OK
05
—
100195450C
—
OK
05
—
100204600A
—
OK
05
—
100252290A
—
OK
05
—
100700040A
—
OK
05
—
100700040E
—
OK
05
—
100784710A
—
OK
05
—
200001840C
—
OK
05
—
200017970A
—
OK
05
—
200075950C
—
OK
05
—
200114640A
—
OK
01
—
241400717
MEDICARE PIN
OK
01
—
241407503
MEDICARE PIN
OK
01
—
243726904
MEDICARE PIN
OK
01
—
249404202
MEDICARE PIN
OK
01
—
24M802409
MEDICARE PIN
OK
01
—
930013792
RAILROAD MEDICARE
OK
01
—
G001501005
MEDICARE PIN
OK
01
—
G001501039
MEDICARE PIN
OK
01
—
G001501064
MEDICARE PIN
OK
01
—
G37001501
MEDICARE PIN
OK
01
—
P00121324
RAILROAD MEDICARE
OK
01
—
P00130952
RAILROAD MEDICARE
OK
01
—
P00216948
RAILROAD MEDICARE
OK
01
—
P00450324
RAILROAD MEDICARE
OK
Enumeration date
07/24/2006
Last updated
07/23/2015
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