NPIMap

Organization Active NPI

CLC - Eufaula Community Hospital, Inc.

Doing business as Community Hospital Lakeview

  • Rural Acute Care Hospital
  • Eufaula, OK
National Provider Identifier
1407081490
Registry record updated May 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
License
2181 Issued in OK
Legal business name
CLC - EUFAULA COMMUNITY HOSPITAL, INC.
Doing business as
Community Hospital Lakeview
Practice address
1 Hospital Drive
Eufaula, OK 74432-0629
Phone
(918) 689-2535
NPI assigned
May 20, 2009
Last updated
May 20, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY LIFECARE COPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rodney Edward Jedlicki
Title
President
Phone
(812) 949-1838

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X 2181 OK Primary

Addresses

Primary practice location

1 Hospital Drive
Eufaula, OK 74432-0629

Mailing address

138 East Spring Street
Suite 200
New Albany, IN 47150-3457
Phone (812) 949-1838

Other identifiers 1

IdentifierTypeStateIssuer
370169OtherOKMEDICARE PROVIDER NUMBER

Other names 1

  • Community Hospital Lakeview Doing business as

National Provider Directory

National Provider Directory
Tax ID family
BHC LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

138 E Spring St
Ste 200
New Albany, IN 47150

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242777600000",
    "number": "1407081490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 EAST SPRING STREET",
            "address_2": "SUITE 200",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471503457",
            "telephone_number": "812-949-1838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DRIVE",
            "city": "EUFAULA",
            "state": "OK",
            "postal_code": "744320629",
            "telephone_number": "918-689-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLC - EUFAULA COMMUNITY HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY LIFECARE COPORATION",
        "enumeration_date": "2009-05-20",
        "last_updated": "2009-05-20",
        "status": "A",
        "authorized_official_last_name": "JEDLICKI",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-949-1838"
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "OK",
            "license": "2181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "370169",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Hospital Lakeview",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eufaula, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.