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SCH370049-03 STILLWATER MEDICAL CENTER AUTHORITY (Terminated)
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Main Details
Name
STILLWATER MEDICAL CENTER AUTHORITY
Subdivision Name
STILLWATER MEDICAL CENTER - HOME HEALTH
Type
Sole Community Hospital
Rural
No
340B ID
SCH370049-03
Medicare Provider Number
370049
Outpatient Facility Provider Number
377204
Additional Details
Current Program Status
Terminated
Registration Date
6/13/2011
Participating Start Date
7/1/2011
Participating Approval Date
6/15/2011
Last Recertification Date
11/6/2017
Termination Date
Termination Reason
4/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
Stillwater Medical Center Authority
ALAN LOVELACE, CHIEF FINANCIAL OFFICER
(405) 742-5729
Primary Contact
Stillwater Medical Center Authority
Leva Swim, VP
(405) 742-5729
Addresses
Street Address
824 SOUTH WALNUT
STILLWATER, OK 74074
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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