Healthcare Provider Details

I. General information

NPI: 1003982620
Provider Name (Legal Business Name): PIATT AND MILLER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 EAST CALIFORNIA
WALTERS OK
73572-0246
US

IV. Provider business mailing address

PO BOX 246 600 EAST CALIFORNIA
WALTERS OK
73572-0246
US

V. Phone/Fax

Practice location:
  • Phone: 580-875-3376
  • Fax: 580-875-3574
Mailing address:
  • Phone: 580-875-3376
  • Fax: 580-875-3574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH17011701
License Number StateOK

VIII. Authorized Official

Name: EVA VIRGINIA FRYER
Title or Position: ADMINISTRATOR
Credential: ADMINISTRATOR
Phone: 580-875-3376