MEDICARE: OAKVIEW MEDICAL CARE FACILITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	2033624	MI
2	314000000X	Skilled Nursing Facility	538510	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427051473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAKVIEW MEDICAL CARE FACILITY

Provider Business Mailing Address
First Line	:	1001 DIANA ST
Second Line	:
City	:	LUDINGTON
State	:	MI
Zip	:	49431-1908
Country	:	US
Telephone Number	:	231-845-5185
Fax Number	:	231-845-7957

Provider Business Practice Location Address
First Line	:	1001 DIANA ST
Second Line	:
City	:	LUDINGTON
State	:	MI
Zip	:	49431-1908
Country	:	US
Telephone Number	:	231-845-5185
Fax Number	:	231-845-7957

Authorized Official
Title or Position	:	DIRECTOR OF FINANCIAL SERVICES
Name	:	MR. NORMAN J WHITE JR.
Credential	:
Telephone Number	:	231-845-5185

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	10/26/2011

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