Organization
MIAMI NURSING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN W. MCGREW (BUSINESS MANAGEMENT)
(918) 775-4439
Entity
Organization
Contact information
Practice address
1100 E ST NE, MIAMI, OK 74354-3435
(918) 542-3335
(918) 542-8159
Mailing address
1100 EAST STREET NORTHEAST, MIAMI, OK 74354-3435
(918) 542-3335
(918) 542-8159
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH5805-5805
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200078990A
—
OK
Enumeration date
09/25/2006
Last updated
08/17/2012
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