Provider Demographics
NPI:1023072923
Name:DUNCAN REGIONAL HOSPITAL PRIVATECARE
Entity type:Organization
Organization Name:DUNCAN REGIONAL HOSPITAL PRIVATECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR , EXTENDED CARE SERVICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:FLO
Authorized Official - Middle Name:
Authorized Official - Last Name:STUCKERT
Authorized Official - Suffix:
Authorized Official - Credentials:RNC
Authorized Official - Phone:580-251-8735
Mailing Address - Street 1:2000 W ELK AVE
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1642
Mailing Address - Country:US
Mailing Address - Phone:580-251-8735
Mailing Address - Fax:580-251-8757
Practice Address - Street 1:2000 W ELK AVE
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1642
Practice Address - Country:US
Practice Address - Phone:580-251-8735
Practice Address - Fax:580-251-8757
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DUNCAN REGIONAL HOSPITAL INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-17
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7597251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health