MEDICARE: ALTUS OPERATIONS L L C

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	314000000X	Skilled Nursing Facility	PENDING	OK

Other Identifiers

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

General Provider Information

NPI Number	:	1992810410
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTUS OPERATIONS L L C

Provider Business Mailing Address
First Line	:	2610 CEDAR CREEK DR
Second Line	:
City	:	ALTUS
State	:	OK
Zip	:	73521-1312
Country	:	US
Telephone Number	:	580-480-1800
Fax Number	:	580-477-2006

Provider Business Practice Location Address
First Line	:	2610 CEDAR CREEK DR
Second Line	:
City	:	ALTUS
State	:	OK
Zip	:	73521-1312
Country	:	US
Telephone Number	:	580-480-1800
Fax Number	:	580-477-2006

Authorized Official
Title or Position	:	DIRECTOR OF RCM
Name	:	KRISTY DEROIN
Credential	:
Telephone Number	:	405-943-1144

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	02/05/2026

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Directions to “ALTUS OPERATIONS L L C ” Practice Location

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