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General NPI Number Information
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NPI Number | 1053997338
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Entity Type | Organization
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Legal Business Name | SOUTHERN PLAINS MEDICAL CENTER OF GARVIN COUNTY LLC
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Dates
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Enumeration Date | 03/18/2021
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 100 VALLEY DR
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City | PAULS VALLEY
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State | OK
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Zip | 73075-6613
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Country | US
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Telephone | 405-866-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 100 VALLEY DR
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City | PAULS VALLEY
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State | OK
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Zip | 73075-6613
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Country | US
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Telephone | 405-866-5100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MADHUKAR SHARMA
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Credential |
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Telephone | 904-238-3752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number |
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License Number State |
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