Blackhawk Mangum, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

BLACKHAWK MANGUM, LLC

Doing business as

Quartz Mountain Healthcare System - Robinson Family Clinic

Practice address

1601 Watts St
Sayre, OK 73662-1314

Phone

(580) 928-9933

NPI assigned

Jul 30, 2014

Last updated

Sep 8, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Lindsay Crabb, CEO

Title

Ceo

Phone

(580) 782-3353

Specialties & licenses 1

Addresses

Other names 1

• Quartz Mountain Healthcare System - Robinson Family Clinic Doing business as

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

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410134400000",
    "number": "1760890040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WICKERSHAM ST",
            "city": "MANGUM",
            "state": "OK",
            "postal_code": "735549117",
            "telephone_number": "580-782-3353",
            "fax_number": "580-782-5944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WATTS ST",
            "city": "SAYRE",
            "state": "OK",
            "postal_code": "736621314",
            "telephone_number": "580-928-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKHAWK MANGUM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-30",
        "last_updated": "2014-09-08",
        "status": "A",
        "authorized_official_last_name": "CRABB",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "580-782-3353",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quartz Mountain Healthcare System - Robinson Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca R Aldava, P.A.
• David Wayne Arles, APRN-CNP
• Sheena Rene' Bagby
• Robbie Barber
• Blackhawk Mangum LLC (Robinson Family Clinic)
• Kendriss Leigh Brown
• Franki Buckner
• Sonya K Carlson, D.PH.
• Sam Carter Sr.
• Cheyenne Professional Drug Inc (City Pharmacy)

• Primary Care Clinic/Center in Sayre, OK
• Providers in Sayre, OK by specialty
• Primary Care Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.