Healthcare Provider Details

I. General information

NPI: 1902395437
Provider Name (Legal Business Name): N & R OF WINDSOR HILLS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2018
Last Update Date: 05/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2416 N ANN ARBOR AVE
OKLAHOMA CITY OK
73127-1811
US

IV. Provider business mailing address

329 TOWNEPARK CIR
LOUISVILLE KY
40243-2348
US

V. Phone/Fax

Practice location:
  • Phone: 405-942-8566
  • Fax: 405-946-4213
Mailing address:
  • Phone: 502-254-9525
  • Fax: 502-254-9524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: JAY TRUMBO
Title or Position: MEMBER
Credential:
Phone: 502-254-9525