Organization
INTEGRIS GROVE HOSPITAL
Active
Other names
Trinity Life Care Home Health Supplies
Organization subpart
No
Provider details
NPI number
Authorized official
CARL BRUCE LAWRENCE (PRESIDENT CEO)
(405) 949-3177
Entity
Organization
Contact information
Practice address
1103 E 13TH STREET, SUITE D, GROVE, OK 74344-5304
(918) 787-3800
Mailing address
PO BOX 450458, GROVE, OK 74345-0458
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
7012
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100699700L
—
OK
Enumeration date
08/15/2007
Last updated
11/04/2011
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