NPI | 1265602056 |
---|---|
Doing Business As | GRAND LAKE MEDICAL PARK - MONKEY ISLAND |
Entity Type | Organization |
Authorized Contact | HERBERT F. CRUM Chief Executive Officer 918-256-7551 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: OK 2182) |
Additional Taxonomies | 282NR1301X General Acute Care Hospital, Rural (Licence: OK 2182) |
Enumeration Date | 2008-03-07 |
Last Update Date | 2015-03-03 |