OrganizationActive
Blackhawk Mangum, LLC
NPI 1922147305 · Critical Access Hospital · Granite, OK
Provider details
- NPI number
- 1922147305
- Entity type
- Organization
- Primary specialty
- Critical Access HospitalHospitals
- Organization subpart
- No
- Authorized official
- Brian Roland, Cfo(580) 782-3353
- License
- 2208 (OK)
Specialties & taxonomies
Hospitals
Practice location
417 North Main St
Granite, OK 73547
Phone: (580) 535-4615
Fax: (580) 535-4466
Approximate (ZIP-level) locationGet directions
Mailing address
One Wickersham Drive
Mangum, OK 73554
Other names (DBA / former)
- Other name
- Mch Granite Family Clinic
Registry dates
- Enumerated
- 2007-02-05
- Last updated
- 2008-04-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.