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General NPI Number Information
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NPI Number | 1871583070
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Entity Type | Organization
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Legal Business Name | CHICKASHA NURSING CENTER INC.
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 2701 S 9TH
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City | CHICKASHA
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State | OK
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Zip | 73018-6739
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Country | US
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Telephone | 405-224-3593
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Fax |
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Provider Business Mailing Address
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Address Line | 2701 S 9TH
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City | CHICKASHA
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State | OK
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Zip | 73018-6739
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Country | US
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Telephone | 405-224-3593
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JAMES M ROBERTSON
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Credential |
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Telephone | 405-224-3593
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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 |
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License Number State | OK
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