MEDICARE: CHEROKEE COUNTY NURSING CENTER INC

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	NH1104-1104	OK

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	:	1578518494
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHEROKEE COUNTY NURSING CENTER INC

Provider Business Mailing Address
First Line	:	415 ROGERS AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72901-1903
Country	:	US
Telephone Number	:	479-783-4672
Fax Number	:	479-783-2217

Provider Business Practice Location Address
First Line	:	1504 N CEDAR AVE
Second Line	:
City	:	TAHLEQUAH
State	:	OK
Zip	:	74464-6700
Country	:	US
Telephone Number	:	918-456-3456
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MICHAEL S. MORTON
Credential	:
Telephone Number	:	479-783-4672

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	06/10/2026

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