Provider Demographics
NPI:1699804708
Name:GREAT PLAINS REGIONAL MEDICAL CENTER
Entity type:Organization
Organization Name:GREAT PLAINS REGIONAL MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MEACHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-562-4868
Mailing Address - Street 1:825 SOONER
Mailing Address - Street 2:
Mailing Address - City:BURNS FLAT
Mailing Address - State:OK
Mailing Address - Zip Code:73624
Mailing Address - Country:US
Mailing Address - Phone:580-562-4868
Mailing Address - Fax:580-562-4581
Practice Address - Street 1:825 SOONER DR.
Practice Address - Street 2:
Practice Address - City:BURNS FLAT
Practice Address - State:OK
Practice Address - Zip Code:73624
Practice Address - Country:US
Practice Address - Phone:580-562-4868
Practice Address - Fax:580-562-4581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3340523336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy