Basic Information
| Provider Information | |||||||||
| NPI: | 1366412744 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SAYRE MEMORIAL HOSPITAL, INC. | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 911 HOSPITAL DRIVE | ||||||||
| Address2: | |||||||||
| City: | SAYRE | ||||||||
| State: | OK | ||||||||
| PostalCode: | 736621206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5809285541 | ||||||||
| FaxNumber: | 5809283523 | ||||||||
| Practice Location | |||||||||
| Address1: | 911 HOSPITAL DRIVE | ||||||||
| Address2: | |||||||||
| City: | SAYRE | ||||||||
| State: | OK | ||||||||
| PostalCode: | 736621206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5809285541 | ||||||||
| FaxNumber: | 5809283523 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2006 | ||||||||
| LastUpdateDate: | 06/10/2015 | ||||||||
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| AuthorizedOfficialLastName: | BATES | ||||||||
| AuthorizedOfficialFirstName: | DONALD | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5809285541 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | JR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 275N00000X | 2207 | OK | Y | Hospital Units | Medicare Defined Swing Bed Unit |
No ID Information.