Organization
OSAGE NURSING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN MCGREW (MEMBER)
(918) 775-4439
Entity
Organization
Contact information
Practice address
822 W OSAGE AVE, NOWATA, OK 74048-3317
(918) 273-2012
(918) 273-3631
Mailing address
PO BOX 429, SALLISAW, OK 74955-0429
(918) 775-4439
(918) 775-9242
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH5303-5303
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200076660A
—
OK
Enumeration date
09/20/2006
Last updated
05/15/2012
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