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NPI Code Detail

MEDICARE: ST SIMEONS EPISCOPAL HOME INC

MEDICARE: ST SIMEONS EPISCOPAL HOME 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
1313M00000XNursing Facility/Intermediate Care FacilityCC7205-7205OK

General Provider Information

NPI Number : 1871867010
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST SIMEONS EPISCOPAL HOME INC
Provider Business Mailing Address
First Line : 3701 N MARTIN LUTHER KING JR BLVD
Second Line :
City : TULSA
State : OK
Zip : 74106-6450
Country : US
Telephone Number : 918-794-1900
Fax Number : 918-425-6368
Provider Business Practice Location Address
First Line : 3701 N MARTIN LUTHER KING JR BLVD
Second Line :
City : TULSA
State : OK
Zip : 74106-6450
Country : US
Telephone Number : 918-794-1900
Fax Number : 918-425-6368
Authorized Official
Title or Position : PRESIDENT/CEO
Name : MS. LINDSAY HURLEY FICK
Credential :
Telephone Number : 918-794-1901
Provider Enumeration Date : 03/06/2012
Last Update Date : 12/20/2013

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Directions to “ST SIMEONS EPISCOPAL HOME INC ” Practice Location

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