Organization
CLC - EUFAULA COMMUNITY HOSPITAL, INC.
Active
Parent organization
COMMUNITY LIFECARE COPORATION
Other names
Community Hospital Lakeview
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY LIFECARE COPORATION
Authorized official
RODNEY EDWARD JEDLICKI (PRESIDENT)
(812) 949-1838
Entity
Organization
Contact information
Practice address
1 HOSPITAL DRIVE, EUFAULA, OK 74432-0629
(918) 689-2535
Mailing address
138 EAST SPRING STREET, SUITE 200, NEW ALBANY, IN 47150-3457
(812) 949-1838
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
2181
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
370169
MEDICARE PROVIDER NUMBER
OK
Enumeration date
05/20/2009
Last updated
05/20/2009
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