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Ok4 Eastgate Opco LLC

Skilled Nursing Facility in Muskogee, OK. Organization (NPI-2).

NPI number1962857482
StatusActive
Last updated in NPPESOct 29, 2024

Details

NPI
1962857482
Entity type
Organization (NPI-2)
Legal business name
Ok4 Eastgate Opco LLC
Organization subpart
No
Enumeration date
May 3, 2016
Certification date
Oct 29, 2024
Last updated
Oct 29, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
314000000X Skilled Nursing Facility–OKYes

Other names

  • Eastgate Village Retirement Center (Doing Business As)

Practice location

3500 Haskell Blvd
Muskogee, OK 74403-3915

Phone 918-682-3191

Mailing address

3500 Haskell Blvd
Muskogee, OK 74403-3915

Phone 918-682-3191

Authorized official

Isaac Dole
Manager/Principal
7736459246

Is something wrong?

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