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General NPI Number Information
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NPI Number | 1124473103
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Entity Type | Organization
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Legal Business Name | ML-OP OXFORD, LLC
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Dates
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Enumeration Date | 04/27/2016
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Last Update Date | 06/08/2016
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Provider Practice Location Address
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Address Line | 200 S OHIO
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City | OXFORD
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State | KS
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Zip | 67119-8080
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Country | US
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Telephone | 620-455-2214
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Fax | 620-455-2497
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Provider Business Mailing Address
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Address Line | PO BOX 509
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City | COFFEYVILLE
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State | KS
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Zip | 67337-0509
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Country | US
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Telephone | 620-709-0342
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT, CHIEF FINANCIAL OFF
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Name | MR. SCOTT L HINES
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Credential | CPA
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Telephone | 620-257-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | N096005
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License Number State | KS
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