Organization
SERVANT LIVING CENTER - MEDFORD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT D PILGRIM (MANAGING MEMBER)
(405) 285-8166
Entity
Organization
Contact information
Practice address
616 S FRONT STREET, MEDFORD, OK 73759
(405) 395-2105
(405) 395-2070
Mailing address
129 W 1ST STREET, SUITE B, EDMOND, OK 73003
(405) 285-8166
(405) 285-8177
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
Other
Enumeration date
07/25/2006
Last updated
08/22/2020
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