Healthcare Provider Details

I. General information

NPI: 1821175662
Provider Name (Legal Business Name): GLENPOOL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 E 141ST ST
GLENPOOL OK
74033-3807
US

IV. Provider business mailing address

PO BOX 1144
GLENPOOL OK
74033-1144
US

V. Phone/Fax

Practice location:
  • Phone: 918-291-4230
  • Fax: 918-291-2429
Mailing address:
  • Phone: 918-291-4230
  • Fax: 918-291-2429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateOK

VIII. Authorized Official

Name: MRS. ELIZABETH CHAPMAN
Title or Position: MANAGER
Credential:
Phone: 918-291-4230