Organization
MERCY HOSPITAL LOGAN COUNTY, INC
Active
Other names
Mercy Hospital Logan County Crescent Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRY CLOUSE DAY (VICE PRESIDENT FINANCE)
(417) 820-8439
Entity
Organization
Contact information
Practice address
400 S GRAND, CRESCENT, OK 73028-9118
(405) 969-2818
Mailing address
400 S GRAND, CRESCENT, OK 73028-9118
(405) 969-2818
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37-3990
MEDICARE PROVIDER #
OK
Enumeration date
08/30/2011
Last updated
09/27/2021
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