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SCH370138-00 MEMORIAL HOSPITAL OF TEXAS COUNTY AUTHORITY (Terminated)
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Main Details
Name
MEMORIAL HOSPITAL OF TEXAS COUNTY AUTHORITY
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH370138-00
Medicare Provider Number
370138
Additional Details
Current Program Status
Terminated
Registration Date
9/14/2010
Participating Start Date
9/29/2010
Participating Approval Date
9/29/2010
Last Recertification Date
12/5/2017
Termination Date
Termination Reason
4/1/2018
Other
Contacts
Authorizing Official
Memorial Hospital of Texas County Authority
Michele Reust, Controller
(580) 338-6515 Ext: 2244
Primary Contact
Memorial Hospital of Texas County Authority
Chet Oblander, Pharmacist in Charge
(580) 338-6515
Addresses
Street Address
520 MEDICAL DRIVE
GUYMON, OK 73942
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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