# GREGSTON NURSING HOME INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366478786
- **Authorized official:** MR. JEFF GREGSTON (ADMINISTRATOR)
- **Authorized official phone:** (580) 658-2319

## Contact information

- **Practice address:** 711 S BROADWAY ST, MARLOW, OK 73055-3313
- **Practice address phone:** (580) 658-2319
- **Practice address fax:** (580) 658-6943
- **Mailing address:** 711 S BROADWAY ST, MARLOW, OK 73055-3313
- **Mailing address phone:** (580) 658-2319
- **Mailing address fax:** (580) 658-6943

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | NH69036903 | OK | — |
| 314000000X | Skilled Nursing Facility | NH69036903 | OK | Yes |

## Other

- **Enumeration date:** 06/25/2006
- **Last updated:** 02/17/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100773070A | — | OK |