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NPI Code Detail

MEDICARE: SKELLY OPERATIONS LLC

MEDICARE: SKELLY OPERATIONS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1033862206
Entity Type Code : Organization
Provider Name (Legal Business Name) : SKELLY OPERATIONS LLC
Provider Business Mailing Address
First Line : PO BOX 990
Second Line :
City : EDMOND
State : OK
Zip : 73083-0990
Country : US
Telephone Number : 405-285-8166
Fax Number :
Provider Business Practice Location Address
First Line : 1815 E SKELLY DR
Second Line :
City : TULSA
State : OK
Zip : 74105-5919
Country : US
Telephone Number : 918-743-7838
Fax Number : 918-738-5970
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : WILLIAM JASON BUSH
Credential :
Telephone Number : 405-285-8166
Provider Enumeration Date : 01/28/2022
Last Update Date : 03/24/2022

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Directions to “SKELLY OPERATIONS LLC ” Practice Location

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