Basic Information
| Provider Information | |||||||||
| NPI: | 1154713089 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SPECIALTY HOSPITAL OF MIDWEST CITY OPERATOR LLC | ||||||||
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| OtherOrganizationName: | SPECIALTY HOSPITAL OF MIDWEST CITY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 CLIFTON AVE | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087013342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143963462 | ||||||||
| FaxNumber: | 2143963482 | ||||||||
| Practice Location | |||||||||
| Address1: | 8210 NATIONAL AVE | ||||||||
| Address2: | |||||||||
| City: | MIDWEST CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731108518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057390800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2015 | ||||||||
| LastUpdateDate: | 03/02/2015 | ||||||||
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| AuthorizedOfficialLastName: | NEUMAN | ||||||||
| AuthorizedOfficialFirstName: | JOE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2143963462 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282E00000X | OK | Y | Hospitals | Long Term Care Hospital |
No ID Information.