| Mercy Hospital Logan County Crescent Primary Care | |
|
400 S Grand Crescent OK 73028-9118 | |
| (405) 969-2818 | |
| Not Available |
| Full Name | Mercy Hospital Logan County Crescent Primary Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 400 S Grand, Crescent, Oklahoma |
| Authorized Official Name and Position | Sherry Clouse Day (VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 4178208439 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Hospital Logan County Crescent Primary Care 400 S Grand Crescent OK 73028-9118 Ph: (405) 969-2818 | Mercy Hospital Logan County Crescent Primary Care 400 S Grand Crescent OK 73028-9118 Ph: (405) 969-2818 |
| NPI Number | 1659652071 |
|---|---|
| Provider Enumeration Date | 08/30/2011 |
| Last Update Date | 09/27/2021 |
| Medicare PECOS PAC ID | 4587836200 |
|---|---|
| Medicare Enrollment ID | O20110930000610 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659652071 | NPI | - | NPPES |
| 37-3990 | Other | OK | MEDICARE PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Ltcnp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 14355 W Crescent Dover Rd, Crescent, OK 73028 Phone: 405-650-5561 Fax: 405-400-2559 | |
Center For Internal Medicine And Pediatrics - Crescent Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 S Grand, Crescent, OK 73028 Phone: 405-969-2818 |