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NPI Code Detail

MEDICARE: ML-OP COFFEYVILLE LLC

MEDICARE: ML-OP COFFEYVILLE 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 : 1952041154
Entity Type Code : Organization
Provider Name (Legal Business Name) : ML-OP COFFEYVILLE LLC
Provider Business Mailing Address
First Line : PO BOX 509
Second Line :
City : COFFEYVILLE
State : KS
Zip : 67337-0509
Country : US
Telephone Number : 620-988-0215
Fax Number :
Provider Business Practice Location Address
First Line : 2921 W 1ST ST
Second Line :
City : COFFEYVILLE
State : KS
Zip : 67337-2441
Country : US
Telephone Number : 620-251-6700
Fax Number :
Authorized Official
Title or Position : PRESIDENT/CEO
Name : MR. SCOTT HINES
Credential :
Telephone Number : 620-709-0305
Provider Enumeration Date : 03/29/2022
Last Update Date : 04/25/2022

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Directions to “ML-OP COFFEYVILLE LLC ” Practice Location

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