OrganizationActive
Blackhawk Mangum, LLC
NPI 1922147305 · Critical Access Hospital · Granite, OK
Blackhawk Mangum, LLC is a Critical Access Hospital organization in Granite, OK (NPI 1922147305).
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
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
417 North Main St
Granite, OK 73547
Phone: (580) 535-4615
Fax: (580) 535-4466
Street-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
Frequently asked questions
- What is Blackhawk Mangum, LLC's NPI number?
- Blackhawk Mangum, LLC's National Provider Identifier (NPI) is 1922147305, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Blackhawk Mangum, LLC?
- Blackhawk Mangum, LLC is classified in the NPPES registry as Critical Access Hospital (Hospitals).
- Where is Blackhawk Mangum, LLC located?
- Blackhawk Mangum, LLC's practice location on file with NPPES is 417 North Main St, Granite, OK 73547.
- What is Blackhawk Mangum, LLC's phone number?
- The practice phone number listed in the NPPES registry for Blackhawk Mangum, LLC is (580) 535-4615.
- Who is the authorized official for Blackhawk Mangum, LLC?
- The authorized official listed on Blackhawk Mangum, LLC's NPPES record is Brian Roland, Cfo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Blackhawk Mangum, LLC's NPI active?
- Yes — Blackhawk Mangum, LLC's NPI (1922147305) is active in the NPPES registry as of the last update on 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.