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General NPI Number Information
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NPI Number | 1508041302
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Entity Type | Organization
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Legal Business Name | ODVA NORMAN DIVISION
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Dates
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Enumeration Date | 12/31/2007
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Last Update Date | 12/31/2007
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Provider Practice Location Address
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Address Line | 1776 E ROBINSON ST
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City | NORMAN
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State | OK
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Zip | 73071-7442
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Country | US
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Telephone | 405-360-5600
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Fax | 405-364-8432
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Provider Business Mailing Address
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Address Line | 1776 E ROBINSON ST
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City | NORMAN
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State | OK
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Zip | 73071-7442
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Country | US
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Telephone | 405-360-5600
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Fax | 405-364-8432
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ROBERT WEEKS
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Credential |
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Telephone | 405-360-5600
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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 | WVC2007-0004
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License Number State | OK
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