# FARWEST HEALTHCARE INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bell Avenue Nursing Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336258409
- **Authorized official:** MR. ALEX WADE DOUT (SEC/TREAS)
- **Authorized official phone:** (918) 333-9545

## Contact information

- **Practice address:** 2301 BELL AVE, ELK CITY, OK 73644-2254
- **Practice address phone:** (580) 225-3335
- **Practice address fax:** (580) 225-6383
- **Mailing address:** 2301 BELL AVE, ELK CITY, OK 73644-2254
- **Mailing address phone:** (580) 225-3335
- **Mailing address fax:** (580) 225-6383

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | NH05050505 | OK | — |
| 314000000X | Skilled Nursing Facility | NH05050505 | OK | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 07/27/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 030378262 | TAX ID | OK |
| 05 | — | 100770720A | — | OK |