Healthcare Provider Details

I. General information

NPI: 1427770411
Provider Name (Legal Business Name): ELMBROOK OF HUGO OPERATING CO., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2022
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 W FINLEY ST
HUGO OK
74743-2300
US

IV. Provider business mailing address

1908 12TH AVE NW STE E
ARDMORE OK
73401-1255
US

V. Phone/Fax

Practice location:
  • Phone: 580-326-8383
  • Fax: 580-326-6183
Mailing address:
  • Phone: 580-226-3055
  • Fax: 580-226-3121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. TOM C COBLE
Title or Position: MANAGING MEMBER
Credential:
Phone: 580-226-3055