Provider Demographics
NPI:1770804395
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:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:P
Authorized Official - Last Name:ENLOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-752-3161
Mailing Address - Street 1:2115 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:EL RENO
Mailing Address - State:OK
Mailing Address - Zip Code:73036-2109
Mailing Address - Country:US
Mailing Address - Phone:
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:405-295-1360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY HOSPITAL EL RENO, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-17
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance