Provider Demographics
NPI:1679751986
Name:PURCELL MUNICIPAL HOSPITAL
Entity type:Organization
Organization Name:PURCELL MUNICIPAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE BUSINESS OFFICE MGR.
Authorized Official - Prefix:
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SPENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-527-2216
Mailing Address - Street 1:PO BOX 511
Mailing Address - Street 2:
Mailing Address - City:PURCELL
Mailing Address - State:OK
Mailing Address - Zip Code:73080-0511
Mailing Address - Country:US
Mailing Address - Phone:405-527-6524
Mailing Address - Fax:405-527-6963
Practice Address - Street 1:1500 N GREEN AVE
Practice Address - Street 2:
Practice Address - City:PURCELL
Practice Address - State:OK
Practice Address - Zip Code:73080-1642
Practice Address - Country:US
Practice Address - Phone:405-527-6524
Practice Address - Fax:405-527-6963
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PURCELL MUNICIPAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-08
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2280275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK37U158Medicare Oscar/Certification