Eastgate Village LLC
Skilled Nursing Facility in Muskogee, OK. Organization (NPI-2).
NPI number1083663512
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1083663512
- Entity type
- Organization (NPI-2)
- Legal business name
- Eastgate Village LLC
- Organization subpart
- No
- Enumeration date
- May 10, 2006
- Last updated
- Sep 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | NH5113-5113 | OK | Yes |
| 313M00000X | Nursing Facility/Intermediate Care Facility | NH5113-5113 | OK |
Practice location
3500 Haskell BlvdMuskogee, OK 74403-3915
Phone 918-682-3191 · Fax 918-682-1131
Mailing address
3500 Haskell BlvdMuskogee, OK 74403-3915
Phone 918-682-3191 · Fax 918-682-1131
Authorized official
Mary Louise Fletcher
Administrator
9186823191
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All 12 Skilled Nursing Facility providers in Muskogee · All 2,229 providers in Muskogee
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