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Organization

CORDELL MEMORIAL HOSPITAL 0189

Active
Parent organization
CORDELL MEMORIAL HOSPITAL 0189
Other names
Cordell Hospital Authority dba Cordell Memorial Hospital Ambulance Ser
Organization subpart
Yes

Provider details

NPI number
Legal business name
CORDELL MEMORIAL HOSPITAL 0189
Authorized official
MR. LANDON E HISE (CEO)
(580) 832-3339
Entity
Organization

Contact information

Practice address
1220 N GLENN L ENGLISH ST, CORDELL, OK 73632-2010
(580) 832-3339
(580) 832-5076
Mailing address
1220 N GLENN L ENGLISH ST, CORDELL, OK 73632-2010
(580) 832-3339
(580) 832-5076

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
EMS211
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000370186001
BCBS OF OKLAHOMA
OK
05
100819200A
OK
05
100819200B
OK
Enumeration date
07/07/2005
Last updated
09/22/2014
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