Organization
MONTEREAU INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROD WEAVER (DIRECTOR OF ACCOUNTING)
(918) 491-5222
Entity
Organization
Contact information
Practice address
6800 S GRANITE AVE, TULSA, OK 74136-7039
(918) 491-5222
Mailing address
6800 S GRANITE AVE, TULSA, OK 74136-7039
(918) 491-5222
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
CC7204-7204
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000375460001
BLUE CROSS BLUE SHIELD
OK
Enumeration date
11/01/2005
Last updated
08/22/2020
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