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SCH370019-01 Farmers Union Hospital Association DBA Great Plains Regional Medical Center (Active)
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Main Details
Name
Farmers Union Hospital Association DBA Great Plains Regional Medical Center
Subdivision Name
GREAT PLAINS PAT WALL CLINIC - Rural Health Clinic
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH370019-01
Medicare Provider Number
370019
Outpatient Facility Provider Number
378526
Additional Details
Current Program Status
Active
Registration Date
7/14/2021
Participating Start Date
10/1/2021
Participating Approval Date
8/5/2021
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Great Plains Regional Medical Center
Monica Scott, CFO
(580) 821-5500
Primary Contact
Great Plains Regional Medical Center
Theresa Garner, Director of Pharmacy
(580) 821-5394
Addresses
Street Address
1800 W FIRST STREET
SUITE 101, 102, 103, 105
ELK CITY, OK 73644
Billing Address
Great Plains Regional Medical Center
PO Box 2339
Elk City, OK 73648
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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