Grand Lake Medical And Wellness Corp
LBN: Grand Lake Medical And Wellness Corp
Grand Lake Medical And Wellness Corp is an health care organization with primary practice located at 101 W Quesenbury Ave , Sallisaw OK 74955-3613. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Primary Care, Ambulatory Health Care Facilities / Pain. Ambulatory Health Care Facilities / Pain is the primary health care specialty.
Grand Lake Medical And Wellness Corp can be contacted via phone (918) 235-6877, or through Wilson, Serena B via phone (918) 961-1658.
Contact Information
Primary practice address
101 W Quesenbury Ave
Sallisaw OK 74955-3613
Phone: (918) 235-6877
Fax:
Website:
Authorized official contact:
Name: Wilson, Serena B Advanced Practice Registered Nurse (APRN)
Phone: (918) 961-1658
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | ||
| Ambulatory Health Care Facilities / Pain | 261QP3300X |
Profile Details
| NPI number | 1336706118 |
|---|---|
| LBN Legal business name | Grand Lake Medical And Wellness Corp |
| DBA Doing business as | |
| Authorized official | Wilson, Serena B Advanced Practice Registered Nurse (APRN) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 28th, 2019 |
| Last updated | May 28th, 2019 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
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