Organization
MEDICALODGES, INC.
Active
Other names
Medicalodges Dewey
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT L HINES (CHIEF FINANCIAL OFFICER)
(620) 709-0305
Entity
Organization
Contact information
Practice address
430 BARTLES ROAD, DEWEY, OK 74029-0520
(918) 534-2848
(918) 534-2558
Mailing address
430 BARTLES ROAD, P.O. BOX 520, DEWEY, OK 74029-0520
(918) 534-2848
(918) 534-2558
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH74047404
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100773540A
—
OK
Enumeration date
10/17/2006
Last updated
11/01/2011
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