MEDICARE: BARTLESVILLE CARE CENTER 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	314000000X	Skilled Nursing Facility	NH7403-7403	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

General Provider Information

NPI Number	:	1710980552
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARTLESVILLE CARE CENTER INC.

Provider Business Mailing Address
First Line	:	3434 KENTUCKY PL
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-2339
Country	:	US
Telephone Number	:	918-333-9545
Fax Number	:	918-333-9601

Provider Business Practice Location Address
First Line	:	3434 KENTUCKY PL
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-2339
Country	:	US
Telephone Number	:	918-333-9545
Fax Number	:	918-333-9601

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	KENNETH CORDELL RUMSEY
Credential	:
Telephone Number	:	918-333-9545

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	05/05/2025

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