Provider Demographics
NPI:1053381947
Name:SMH ACQUISITION,LLC
Entity type:Organization
Organization Name:SMH ACQUISITION,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-821-0435
Mailing Address - Street 1:911 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:SAYRE
Mailing Address - State:OK
Mailing Address - Zip Code:73662-1206
Mailing Address - Country:US
Mailing Address - Phone:580-323-9692
Mailing Address - Fax:580-323-9820
Practice Address - Street 1:911 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:OK
Practice Address - Zip Code:73662-1206
Practice Address - Country:US
Practice Address - Phone:580-323-9692
Practice Address - Fax:580-323-9820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2207282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100700160AMedicaid
OK370103Medicare Oscar/Certification
OK100700160AMedicaid