BLACKHAWK MANGUM LLC

MANGUM, OK
NPI1104008168
Doing Business AsQUARTZ MOUNTAIN MEDICAL CENTER
Entity TypeOrganization
Authorized ContactDAYNA HEINE
Insurance Credentialing Supervisor
979-830-8529
Organization Subpart ?No
Primary Taxonomy275N00000X Medicare Defined Swing Bed Unit
(Licence: OK  2208)
Enumeration Date2007-12-03
Last Update Date2009-11-19
Business Address
BLACKHAWK MANGUM LLC
ONE WICKERSHAM DRIVE
MANGUM, OK 73554
Phone number: 580-782-3353
Mailing Address
BLACKHAWK MANGUM LLC
PO BOX 280
MANGUM, OK 73554-0280
Phone number:
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