Healthcare Provider Details
I. General information
NPI: 1184909020
Provider Name (Legal Business Name): PF MPW SNF OPS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/11/2011
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3110 HEALTHPLEX PKWY
NORMAN OK
73072-9705
US
IV. Provider business mailing address
1500 WATERS RIDGE DR STE 100
LEWISVILLE TX
75057-6056
US
V. Phone/Fax
- Phone: 405-321-2188
- Fax: 405-321-2171
- Phone: 214-725-2837
- Fax: 469-312-3796
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | NH1418-1418 |
| License Number State | OK |
VIII. Authorized Official
Name:
JAMES
M
CHANCE
Title or Position: AUTHORIZED OFFICER
Credential:
Phone: 214-725-2837