Organization
FARWEST HEALTHCARE INC.
Active
Other names
Bell Avenue Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEX WADE DOUT (SEC/TREAS)
(918) 333-9545
Entity
Organization
Contact information
Practice address
2301 BELL AVE, ELK CITY, OK 73644-2254
(580) 225-3335
(580) 225-6383
Mailing address
2301 BELL AVE, ELK CITY, OK 73644-2254
(580) 225-3335
(580) 225-6383
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
NH05050505
OK
314000000X
Skilled Nursing Facility
Primary
NH05050505
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030378262
TAX ID
OK
05
—
100770720A
—
OK
Enumeration date
08/30/2006
Last updated
07/27/2009
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