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NPI Code Detail

MEDICARE: WADLEY CARE CENTER

MEDICARE: WADLEY CARE 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
1314000000XSkilled Nursing Facility375286OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972509172
Entity Type Code : Organization
Provider Name (Legal Business Name) : WADLEY CARE CENTER
Provider Business Mailing Address
First Line : P.O. BOX 1675
Second Line :
City : PURCELL
State : OK
Zip : 73080-1675
Country : US
Telephone Number : 405-527-7798
Fax Number : 405-527-5175
Provider Business Practice Location Address
First Line : 801 N. 6TH STREET
Second Line :
City : PURCELL
State : OK
Zip : 73080
Country : US
Telephone Number : 405-527-7798
Fax Number : 405-527-5175
Authorized Official
Title or Position : OWNER
Name : MR. DAVID WADLEY
Credential :
Telephone Number : 405-527-7798
Provider Enumeration Date : 06/22/2005
Last Update Date : 11/01/2013

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Directions to “WADLEY CARE CENTER ” Practice Location

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