Healthcare Provider Details

I. General information

NPI: 1841384062
Provider Name (Legal Business Name): WESTERN HEALTH MANAGEMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 02/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ARAPAHO AVE.
HYDRO OK
73048-0070
US

IV. Provider business mailing address

PO BOX 130
HYDRO OK
73048-0070
US

V. Phone/Fax

Practice location:
  • Phone: 405-663-2455
  • Fax: 405-663-2443
Mailing address:
  • Phone: 866-403-2003
  • Fax: 877-505-4114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH06040604
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH0604-0604
License Number StateOK

VIII. Authorized Official

Name: BARNEY KENT ABBOTT
Title or Position: PRES / OWNER
Credential:
Phone: 866-403-2003