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General NPI Number Information
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NPI Number | 1578550331
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Entity Type | Organization
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Legal Business Name | SEMINOLE NURSING HOME INC
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Dates
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Enumeration Date | 10/05/2005
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 1705 BOREN BLVD
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City | SEMINOLE
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State | OK
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Zip | 74868-2725
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Country | US
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Telephone | 405-382-1270
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Fax | 405-382-3199
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Provider Business Mailing Address
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Address Line | 1705 BOREN BLVD
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City | SEMINOLE
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State | OK
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Zip | 74868-2725
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Country | US
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Telephone | 405-382-1270
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Fax | 405-382-3199
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Authorized Official
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Title or Position | INSURANCE/MEDICARE
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Name | JANICE PITA
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Credential |
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Telephone | 580-622-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | NH6704-6704
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License Number State | OK
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