BLACKHAWK MANGUM, LLC – NPI #1922147305
General Acute Care Hospital

BLACKHAWK MANGUM, LLC is a general acute care hospital located in GRANITE, OK. NPPES has assigned the NPI number 1922147305 to BLACKHAWK MANGUM, LLC on February 05, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. BLACKHAWK MANGUM, LLC is also known by the name MCH GRANITE FAMILY CLINIC. The primary taxonomy selected by this provider is 282NC0060X from the Health Care Provider Taxonomy code set, which is classified as General Acute Care Hospital, specializing in Critical Access

The NPI profile was previously updated about 18 years ago on Apr 20, 2008. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BLACKHAWK MANGUM, LLC below.

NPI Profile for
BLACKHAWK MANGUM, LLC

NPI Number
1922147305
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BLACKHAWK MANGUM, LLC
Other Name: MCH GRANITE FAMILY CLINIC
Primary location
417 NORTH MAIN ST
GRANITE, OK 73547
Phone: (580) 535-4615 Fax: (580) 535-4466
Mailing address
ONE WICKERSHAM DRIVE
MANGUM, OK 73554
Phone: (580) 782-3353 Fax: (580) 782-5944
Organization Subpart
No
Authorized Official
BRIAN ROLAND
CFO
Phone: (580) 782-3353
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
282NC0060X
- General Acute Care Hospital / Critical Access (Primary)		 OK 2208

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.