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SCH370049-00 STILLWATER MEDICAL CENTER AUTHORITY (Active)
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Main Details
Name
STILLWATER MEDICAL CENTER AUTHORITY
Subdivision Name
Type
Sole Community Hospital
Rural
No
340B ID
SCH370049-00
Medicare Provider Number
370049
Additional Details
Current Program Status
Active
Registration Date
4/18/2011
Participating Start Date
7/1/2011
Participating Approval Date
6/15/2011
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Stillwater Medical Center Authority
ALAN LOVELACE, CHIEF FINANCIAL OFFICER
(405) 742-5729
Primary Contact
Stillwater Medical Center
Patrick Bryce Simpson, Compliance Analyst
(405) 533-8696
Addresses
Street Address
1323 W. 6TH Ave
STILLWATER, OK 74074-4306
Billing Address
STILLWATER MEDICAL CENTER AUTHORITY
P.O. BOX 2408
STILLWATER, OK 74076-2408
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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8/26/11 updated addr.(1323 W. SIXTH STREET)
08/26/2011
May 2025
May 2025
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