Provider Demographics
NPI:1619498896
Name:GPCH, LLC
Entity Type:Organization
Organization Name:GPCH, LLC
Other - Org Name:STINNETT MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:R
Authorized Official - Last Name:SLATON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-878-2271
Mailing Address - Street 1:100 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:BORGER
Mailing Address - State:TX
Mailing Address - Zip Code:79007-7579
Mailing Address - Country:US
Mailing Address - Phone:806-878-2271
Mailing Address - Fax:806-878-2272
Practice Address - Street 1:711 S STEWART AVE
Practice Address - Street 2:
Practice Address - City:STINNETT
Practice Address - State:TX
Practice Address - Zip Code:79083
Practice Address - Country:US
Practice Address - Phone:806-878-2271
Practice Address - Fax:806-878-2272
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GPCH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-28
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health