Organization Name: | GREAT PLAINS REGIONAL MEDICAL CENTER |
NPI Number: | 1114392875 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | COREY LIVELY (CEO) |
Mailing Address: | 1801 W 3rd St Elk City |
State: | OK US |
Postal Code: | 736445145 |
Phone Number: | 5802252511 |
Fax Number: | |
NPI Enumeration Date: | 12/07/2015 |
NPI Last Update Date: | 12/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 282NW0100X |
License Number: | 99035 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Hospitals |
Taxonomy Classification: | General Acute Care Hospital |
Taxonomy Specialization: | Women |
Taxonomy Definition: |