MEDICARE: AMBERWOOD NURSING CENTER

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	313M00000X	Nursing Facility/Intermediate Care Facility	NH5542-5542	OK

General Provider Information

NPI Number	:	1659351641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMBERWOOD NURSING CENTER

Provider Business Mailing Address
First Line	:	5900 N ROBINSON AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-7451
Country	:	US
Telephone Number	:	405-843-5900
Fax Number	:	405-842-0994

Provider Business Practice Location Address
First Line	:	5900 N ROBINSON AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-7451
Country	:	US
Telephone Number	:	405-843-5900
Fax Number	:	405-842-0994

Authorized Official
Title or Position	:	CO-OWNER AND CEO
Name	:	MR. DENVER EUGENE MCCORMICK
Credential	:
Telephone Number	:	405-616-2144

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	09/06/2023

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Directions to “AMBERWOOD NURSING CENTER ” Practice Location

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