Organization
FARMERS UNION HOSPITAL ASSOCIATION
Active
Other names
Great Plains Pat Wall Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
COREY LIVELY (CEO)
(580) 821-5300
Entity
Organization
Contact information
Practice address
1800 W 1ST ST, SUITES 101, 102, 103 AND 105, ELK CITY, OK 73644-3133
(580) 225-2515
(580) 303-5850
Mailing address
PO BOX 2339, ELK CITY, OK 73648-2339
(580) 225-2511
(580) 225-9143
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/21/2018
Last updated
07/30/2025
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