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Organization
CARRUS LAKESIDE HOSPITAL LLC
Active
Organization
CARRUS LAKESIDE HOSPITAL LLC
Active
Other names
Carrus Lakeside Rural Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ANBU NACHIMUTHU (CHAIRMAN/CEO)
(903) 870-2745
Entity
Organization
Contact information
Practice address
700 W 7TH AVE STE 102, BRISTOW, OK 74010-2302
(918) 367-2215
(918) 367-4481
Mailing address
1810 W US HIGHWAY 82, SHERMAN, TX 75092-7069
(903) 870-2745
(903) 870-2795
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
09/13/2023
Last updated
09/13/2023
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