Alva Hospital Authority/Dba Share Medical Center
Organization Active NPI Clinic/Center · Freedom, OK
NPI 1477138352 · NPPES record last updated Mar 12, 2021
Key facts
- NPI
- 1477138352
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- ALVA HOSPITAL AUTHORITY/DBA SHARE MEDICAL CENTER
- Practice address
- 957 Eagle Pass
Freedom, OK 73842 - Phone
- (580) 430-3333
- Fax
- (580) 430-3305
- NPI assigned
- Mar 12, 2021
- Organization subpart
- Yes
- Parent organization (as reported)
- ALVA HOSPITAL AUTHORITY/DBA SHARE MEDICAL CENTER
Authorized official
- Name
- Kandice Allen
- Title
- Ceo
- Phone
- (580) 430-3309
Other NPIs on the same Medicare enrollment 5
Practitioners 2
-
Jessica Rayleen Jones, APRN-CNP
-
Steve M Madrid, PA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040514000014 | OK | Part B Supplier - Clinic/Group Practice | 5597755306 |
Receives reassigned benefits from 26 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Alva, OK |
National Provider Directory
- Part of
- Share Health Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
957 Eagle Pass
Freedom, OK 73842
Mailing address
800 Share Dr
Alva, OK 73717-3618
Phone (580) 327-2800
Other names
- SMC Freedom Medical Clinic
Other providers in Freedom, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.