BLACKHAWK MANGUM LLC NPI 1992737613

NPI Information

NPI: 1992737613
Provider Name: BLACKHAWK MANGUM LLC

Doing Business As: QUARTZ MOUNTAIN MEDICAL CENTER

Classification: General Acute Care Hospital - 282NC0060X
Entity Type: Organization

Specialization: Critical Access

Address:
ONE WICKERSHAM DR
MANGUM, OK
ZIP 73554
Phone: (580) 782-3353
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BLACKHAWK MANGUM LLC is a critical access general acute care hospital in Mangum, OK. BLACKHAWK MANGUM LLC NPI is 1992737613. The provider is registered as an organization entity type.
The provider Is Doing Business As Quartz Mountain Medical Center.

The provider's business location address is:

ONE WICKERSHAM DR
MANGUM, OK
ZIP 73554-117
Phone: (580) 782-3353
Fax: (580) 782-5944

The provider's authorized official is Dayna Heine .
The authorized official title is Credential and has the following contact phone number (979) 830-8529.

The enumeration date for this NPI number is 7/6/2006 and was last updated on 11/19/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	282NC0060X	General Acute Care Hospital	Critical Access	2208	OKLAHOMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	500522139	MEDICARE OSCAR/CERTIFICATION	OKLAHOMA
2	100699750A	MEDICAID	OKLAHOMA
3	100699750B	MEDICAID	OKLAHOMA
4	371330	MEDICARE OSCAR/CERTIFICATION	OKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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