Provider Demographics
NPI:1093917890
Name:PARKVIEW HOSPITAL
Entity Type:Organization
Organization Name:PARKVIEW HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCINDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:CARMICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-295-1000
Mailing Address - Street 1:1102 S MACOMB AVE
Mailing Address - Street 2:
Mailing Address - City:EL RENO
Mailing Address - State:OK
Mailing Address - Zip Code:73036-4730
Mailing Address - Country:US
Mailing Address - Phone:405-262-4303
Mailing Address - Fax:
Practice Address - Street 1:2115 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036-2109
Practice Address - Country:US
Practice Address - Phone:405-262-2640
Practice Address - Fax:405-295-1349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1600438282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1600438OtherLICENSE #
OK100089650AMedicaid
OK242420403Medicare ID - Type Unspecified
OK100089650AMedicaid