Provider Demographics
NPI:1245225978
Name:PARKVIEW HOSPITAL
Entity Type:Organization
Organization Name:PARKVIEW HOSPITAL
Other - Org Name:PARKVIEW HOSPITAL HOME HEALTH
Other - Org Type:Doing Business As
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 1:2115 PARKVIEW DR
Mailing Address - Street 2:PO BOX 129
Mailing Address - City:EL RENO
Mailing Address - State:OK
Mailing Address - Zip Code:73036-2109
Mailing Address - Country:US
Mailing Address - Phone:405-262-6877
Mailing Address - Fax:405-422-2558
Practice Address - Street 1:2315 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036-2149
Practice Address - Country:US
Practice Address - Phone:405-262-6877
Practice Address - Fax:405-422-2558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-19
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7243251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100700930CMedicaid
OK377091Medicare Oscar/Certification