Organization
MOORE NURSING HOME INC
Active
Other names
East Moore Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE PITA (INSURANCE/MEDICARE)
(580) 622-6300
Entity
Organization
Contact information
Practice address
320 N EASTERN AVE, MOORE, OK 73160-6920
(405) 794-0224
(405) 794-6287
Mailing address
320 N EASTERN AVE, MOORE, OK 73160-6920
(405) 794-0224
(405) 794-6287
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH1408-1408
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000375441001
BLUE CROSS/BLUE SHIELD
OK
05
—
200011250A
—
OK
Enumeration date
10/04/2005
Last updated
06/16/2008
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