Organization
SOUTHBROOK HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM C COBLE (OWNER)
(580) 226-3055
Entity
Organization
Contact information
Practice address
832 ISABEL ST, ARDMORE, OK 73401-5118
(580) 223-5901
(580) 226-0841
Mailing address
832 ISABEL ST, ARDMORE, OK 73401-5118
(580) 223-5901
(580) 226-0841
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH1006-1006
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100777570A
—
OK
Enumeration date
07/19/2005
Last updated
03/07/2016
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