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NPI Code Detail

MEDICARE: PARC PLACE OPERATIONS LLC

MEDICARE: PARC PLACE OPERATIONS LLC
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
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1801470265
Entity Type Code : Organization
Provider Name (Legal Business Name) : PARC PLACE OPERATIONS LLC
Provider Business Mailing Address
First Line : PO BOX 990
Second Line :
City : EDMOND
State : OK
Zip : 73083-0990
Country : US
Telephone Number : 405-285-8166
Fax Number : 405-563-9447
Provider Business Practice Location Address
First Line : 1400 E MEMORIAL RD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73131-1240
Country : US
Telephone Number : 405-285-8166
Fax Number :
Authorized Official
Title or Position : MANAGING MEMBER
Name : MR. SCOTT D. PILGRIM
Credential :
Telephone Number : 918-366-4492
Provider Enumeration Date : 05/11/2021
Last Update Date : 05/11/2021

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Directions to “PARC PLACE OPERATIONS LLC ” Practice Location

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