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General NPI Number Information
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NPI Number | 1972773448
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Entity Type | Organization
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Legal Business Name | CLAREMORE INDIAN HOSPITAL
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Dates
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Enumeration Date | 03/11/2008
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 101 SOUTH MOORE AVENUE
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City | CLAREMORE
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State | OK
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Zip | 74017
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Country | US
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Telephone | 918-342-6200
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Fax | 918-342-6436
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Provider Business Mailing Address
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Address Line | PO BOX 95431
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City | CLEVELAND
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State | OH
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Zip | 44101-0033
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Country | US
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Telephone | 918-342-6200
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Fax | 918-342-6248
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. GEORGE L VALLIERE
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Credential |
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Telephone | 918-342-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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