Organization
GRADY MEMORIAL HOSPITAL
Active
Other names
Five Oaks Family Medical Clinic DME
Organization subpart
No
Provider details
NPI number
Authorized official
WARREN KEAN SPELLMAN (CEO)
(405) 779-2150
Entity
Organization
Contact information
Practice address
2100 W IOWA AVE STE A, CHICKASHA, OK 73018-2736
(405) 224-2100
(405) 779-2310
Mailing address
2100 W IOWA AVE STE A, CHICKASHA, OK 73018-2736
(405) 224-2100
(405) 779-2310
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100700820E
—
OK
Enumeration date
07/27/2006
Last updated
03/17/2018
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