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Organization
SEMINOLE NURSING HOME INC
Active
Organization
SEMINOLE NURSING HOME INC
Active
Other names
Seminole Pioneer Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE PITA (INSURANCE/MEDICARE)
(580) 622-6300
Entity
Organization
Contact information
Practice address
1705 BOREN BLVD, SEMINOLE, OK 74868-2725
(405) 382-1270
(405) 382-3199
Mailing address
1705 BOREN BLVD, SEMINOLE, OK 74868-2725
(405) 382-1270
(405) 382-3199
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH6704-6704
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000375350001
BLUE CROSS BLUE SHIELD OK
OK
05
—
200004720A
—
OK
Enumeration date
10/05/2005
Last updated
06/16/2008
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