Provider Demographics
NPI:1407214620
Name:MERCY HOSPITAL EL RENO, INC
Entity Type:Organization
Organization Name:MERCY HOSPITAL EL RENO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-WEST COMMUNITIES
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-752-3085
Mailing Address - Street 1:2001 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:EL RENO
Mailing Address - State:OK
Mailing Address - Zip Code:73036-2107
Mailing Address - Country:US
Mailing Address - Phone:405-262-2640
Mailing Address - Fax:
Practice Address - Street 1:2001 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036-2107
Practice Address - Country:US
Practice Address - Phone:405-262-2640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy