NPIMap

Organization Active NPI

Coal County General Hospital

  • Clinic/Center
  • Coalgate, OK
National Provider Identifier
1750459756
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
2201 Issued in OK
Legal business name
COAL COUNTY GENERAL HOSPITAL
Practice address
6 N Covington St
Coalgate, OK 74538-2002
Phone
(580) 927-2327
Fax
(580) 927-2432
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Trent A. Bourland
Title
Ceo
Phone
(580) 927-2327

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 2201 OK Primary

Addresses

Primary practice location

6 N Covington St
Coalgate, OK 74538-2002

Mailing address

PO Box 326
Coalgate, OK 74538-0326
Phone (580) 927-2327

Other identifiers 1

IdentifierTypeStateIssuer
100774650CMedicaidOK

Other names 1

  • MARY HURLEY HOSPITAL Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041012000102 OK Part B Supplier - Clinic/Group Practice 8022901396 Receives reassigned benefits from 8 practitioners
Practice locations: Coalgate, OK

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670198400000",
    "number": "1750459756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 326",
            "city": "COALGATE",
            "state": "OK",
            "postal_code": "745380326",
            "telephone_number": "580-927-2327",
            "fax_number": "580-927-2439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 N COVINGTON ST",
            "city": "COALGATE",
            "state": "OK",
            "postal_code": "745382002",
            "telephone_number": "580-927-2327",
            "fax_number": "580-927-2432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAL COUNTY GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A",
        "authorized_official_last_name": "BOURLAND",
        "authorized_official_first_name": "TRENT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "580-927-2327",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OK",
            "license": "2201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100774650C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARY HURLEY HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MARY HURLEY HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coalgate, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.