Basic Information
| Provider Information | |||||||||
| NPI: | 1013083906 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PAULS VALLEY GENERAL HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 918 E 7TH ST | ||||||||
| Address2: | |||||||||
| City: | SULPHUR | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730865023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5806222255 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 VALLEY DR | ||||||||
| Address2: | |||||||||
| City: | PAULS VALLEY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730756613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052385501 | ||||||||
| FaxNumber: | 4052389261 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/24/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | JOHNSTON | ||||||||
| AuthorizedOfficialFirstName: | CHARLES | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 4052385501 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 224778 | OK | Y | Hospitals | General Acute Care Hospital |
No ID Information.