# SEMINOLE NURSING HOME INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Seminole Pioneer Nursing Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578550331
- **Authorized official:** JANICE PITA (INSURANCE/MEDICARE)
- **Authorized official phone:** (580) 622-6300

## Contact information

- **Practice address:** 1705 BOREN BLVD, SEMINOLE, OK 74868-2725
- **Practice address phone:** (405) 382-1270
- **Practice address fax:** (405) 382-3199
- **Mailing address:** 1705 BOREN BLVD, SEMINOLE, OK 74868-2725
- **Mailing address phone:** (405) 382-1270
- **Mailing address fax:** (405) 382-3199

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | NH6704-6704 | OK | Yes |

## Other

- **Enumeration date:** 10/05/2005
- **Last updated:** 06/16/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000375350001 | BLUE CROSS BLUE SHIELD OK | OK |
| 05 | — | 200004720A | — | OK |