SERVANT LIVING CENTER - MEDFORD LLC (NPI# 1457374332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457374332 |
| Entity Type | Organization |
| Organization Name | SERVANT LIVING CENTER - MEDFORD LLC |
| Practice Address |
616 S Front Street Medford OK 73759 |
| Mailing Address |
129 W 1st Street Suite B Edmond OK 73003 |
| Practice Telephone | 4053952105 |
| Practice Fax Number | 4053952070 |
| Mailing Telephone | 4052858166 |
| Mailing Fax Number | 4052858177 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. SCOTT D PILGRIM (MANAGING MEMBER) |
| Authorized Official Telephone | 4052858166 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | Nursing & Custodial Care Facilities |
| Street Address |
616 S FRONT STREET |
| City | MEDFORD |
| State | OK |
| Zip Code | 73759 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699025973 | Great Salt Plains Health Center, Inc. | Family Medicine | 619 Front Street, Medford, OK 73759-1209 | 2012-09-14 |
| 1235236175 | Kennedy Drug Co | Pharmacy | 107 E Cherokee St, Medford, OK 73759-1209 | 2006-09-20 |
| 1194072363 | Hughes Pharmacy LLC | Pharmacy | 107 E Cherokee St, Medford, OK 73759-1209 | 2012-08-07 |
| 1891945812 | Amy Holmes Medical Services Plc | Family Medicine | 102 E Cherokee, Medford, OK 73759-1210 | 2008-09-26 |
| 1407049307 | Jonathan D. Wren D.c. | Chiropractor | 104 N Main St, Medford, OK 73759-1232 | 2007-08-23 |
| 1598960015 | Associated Therapeutic Services, PC | Counselor | 114 N Main St, Medford, OK 73759-1232 | 2007-06-15 |
| 1881736577 | Medford Public School | Public Health or Welfare | 301 N Main St, Medford, OK 73759-1234 | 2007-02-12 |
| 1225025455 | Michael F Flanagan, Receiver for Medfors Nursing Home | Skilled Nursing Facility | 616 S Front St, Medford, OK 73759-1714 | 2005-10-03 |
| 1891110797 | Robertson Health Care LLC | Skilled Nursing Facility | 616 S Front St, Medford, OK 73759-1714 | 2014-02-28 |
| 1568424190 | Linda Sue Woodruff | Nurse Practitioner | 158 E Sunset Dr, Suite B, Medford, OK 73759-2401 | 2006-04-06 |
| Find all providers in zip 73759 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932566056 | Medford Adhc | Nursing Facility/Intermediate Care Facility | 101 Mystic Ave, Medford, MA 02155-4628 | 2016-01-20 |
| 1992063820 | Gloria B. Donaii | Nursing Facility/Intermediate Care Facility | 60 Seymour Ln, Medford, NY 11763-1061 | 2012-04-29 |
| 1316267040 | Family Residences and Essential Enterprises | Nursing Facility/Intermediate Care Facility | 35 Hagerman Ave Apt 3, Medford, NY 11763-2145 | 2010-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306455696 | Global Higher Call Nursing, LLC | Nursing Facility/Intermediate Care Facility | 407 Whitebird St, Quapaw, OK 74363-0912 | 2020-07-23 |
| 1336641786 | Sherri Geanette Hilburn | Nursing Facility/Intermediate Care Facility | 225 N. Broadway, Carnegie, OK 73015 | 2018-03-01 |
| 1750891149 | Anadarko Nursing & Rehabilitation LLC | Nursing Facility/Intermediate Care Facility | 300 West Washington, Anadarko, OK 73005 | 2017-10-11 |
| 1659773778 | First Choice Home Medical Inc | Nursing Facility/Intermediate Care Facility | 720 N Galena Ave, Geary, OK 73040-1501 | 2014-09-19 |
| 1467852244 | Jlg Healthcare LLC | Nursing Facility/Intermediate Care Facility | 811 W Elk, Duncan, OK 73533-1196 | 2014-08-28 |
| 1720326622 | Integris Rehab LLC | Nursing Facility/Intermediate Care Facility | 14145 S 220th East Ave, Coweta, OK 74429-6269 | 2013-01-28 |
| 1053617761 | Colonial Park Healthcare Center LLC | Nursing Facility/Intermediate Care Facility | 600 W Frontage Rd, Okemah, OK 74859-6433 | 2011-01-28 |
| 1851562136 | Thomas Health and Rehabilitation LLC | Nursing Facility/Intermediate Care Facility | 601 East Frisco Street, Thomas, OK 73669 | 2008-03-14 |
| 1770768566 | Cox Building Company, Inc. | Nursing Facility/Intermediate Care Facility | 3501 W Washington St, Broken Arrow, OK 74012-9196 | 2007-12-31 |
| 1477745834 | Rehabcare | Nursing Facility/Intermediate Care Facility | 300 Rockefeller, Muskogee, OK 74401-5235 | 2007-08-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.