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SCH370049-02 STILLWATER MEDICAL CENTER AUTHORITY (Active)
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Main Details
Name
STILLWATER MEDICAL CENTER AUTHORITY
Subdivision Name
STILLWATER MEDICAL CENTER - CARDIOLOGY CLINIC
Type
Sole Community Hospital
Rural
No
340B ID
SCH370049-02
Medicare Provider Number
370049
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
6/10/2011
Participating Start Date
7/1/2011
Participating Approval Date
6/15/2011
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Stillwater Medical Center Authority
ALAN LOVELACE, CHIEF FINANCIAL OFFICER
(405) 742-5729
Primary Contact
Stillwater Medical Center Authority
Kari Easson, Controller
(405) 742-5640
Addresses
Street Address
1323 WEST SIXTH STREET
STILLWATER, OK 74074
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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