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General NPI Number Information
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NPI Number | 1396715926
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Entity Type | Organization
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Legal Business Name | CIMARRON MEMORIAL HOSPITAL AND NURSING HOME
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 08/09/2023
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Provider Practice Location Address
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Address Line | 100 S ELLIS
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City | BOISE CITY
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State | OK
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Zip | 73933-1059
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Country | US
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Telephone | 580-544-2501
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Fax | 580-544-2517
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Provider Business Mailing Address
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Address Line | PO BOX 1059
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City | BOISE CITY
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State | OK
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Zip | 73933-1059
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Country | US
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Telephone | 580-544-2501
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Fax | 580-544-2517
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Authorized Official
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Title or Position | CEO
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Name | JONATHAN W GLEASON
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Credential |
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Telephone | 580-589-0231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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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 | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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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 | 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 | OK
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