Organization
CEARU, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT D. PILGRIM (MANAGING MEMBER)
(918) 366-4492
Entity
Organization
Contact information
Practice address
8720 S. 101ST AVE, TULSA, OK 74133
(918) 965-0101
(918) 515-4883
Mailing address
PO BOX 990, EDMOND, OK 73083-0990
(405) 285-8166
(405) 563-9447
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
NH7203-7203
OK
314000000X
Skilled Nursing Facility
Primary
NH7203-7203
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200103940A
—
OK
Enumeration date
04/18/2007
Last updated
02/18/2021
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