# MEDI-HOME OF ARKOMA INC

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

## Provider details

- **NPI number:** 1922101088
- **Authorized official:** ROY RALPH NICHOLS (ADMINISTRATOR)
- **Authorized official phone:** (918) 875-3107

## Contact information

- **Practice address:** 1008 ARKANSAS STREET, ARKOMA, OK 74901-0410
- **Practice address phone:** (918) 875-3107
- **Practice address fax:** (918) 875-3021
- **Mailing address:** PO BOX 410, ARKOMA, OK 74901-0410
- **Mailing address phone:** (918) 875-3107
- **Mailing address fax:** (918) 875-3021

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH4003-4003 | OK | Yes |

## Other

- **Enumeration date:** 09/06/2006
- **Last updated:** 08/27/2007