MEDICARE: CEDAR CREST MANOR INC

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
1	313M00000X	Nursing Facility/Intermediate Care Facility	NH1602-1602	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	37E548	OTHER	OK	FEDERAL ID NUMBER

General Provider Information

NPI Number	:	1689745291
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CEDAR CREST MANOR INC

Provider Business Mailing Address
First Line	:	1700 NW FORT SILL BLVD
Second Line	:
City	:	LAWTON
State	:	OK
Zip	:	73507-4064
Country	:	US
Telephone Number	:	580-355-1616
Fax Number	:	580-355-2814

Provider Business Practice Location Address
First Line	:	1700 NW FORT SILL BLVD
Second Line	:
City	:	LAWTON
State	:	OK
Zip	:	73507-4064
Country	:	US
Telephone Number	:	580-355-1616
Fax Number	:	580-355-2814

Authorized Official
Title or Position	:	BOARD MEMBER
Name	:	MRS. TARRI ALDRIDGE
Credential	:
Telephone Number	:	580-355-1616

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	07/09/2010

Similar Medicare Providers

1679998645 — GARY SPOTTEDHORSE PT
Practice Location Address:

1700 NW FORT SILL BLVD
LAWTON, OK
73507-4064

Practice Phone: 580-355-1616
Practice Fax:

1679209571 — TARA STEWART OTA
Practice Location Address:

1700 NW FORT SILL BLVD
LAWTON, OK
73507-4064

Practice Phone: 580-355-1616
Practice Fax:

1376261974 — JUSTIN WILLIAM THOMPSON
Practice Location Address:

1700 NW FORT SILL BLVD
LAWTON, OK
73507-4064

Practice Phone: 580-465-1829
Practice Fax:

1831968353 — LAWTON POST ACUTE & REHAB,LLC
Practice Location Address:

1700 NW FORT SILL BLVD
LAWTON, OK
73507-4064

Practice Phone: 603-219-3891
Practice Fax:

1922956028 — SHAILAH MAE RAMOS LPC
Practice Location Address:

1515 NE LAWRIE TATUM RD
LAWTON, OK
73507-3099

Practice Phone: 580-354-5120
Practice Fax:

1871935247 — AUDREY NNENNA OBINERO NP-C
Practice Location Address:

1202 NW ARLINGTON AVE
LAWTON, OK
73507-6537

Practice Phone: 580-248-2288
Practice Fax: 580-699-3316

Directions to “CEDAR CREST MANOR INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.