NPI 1053095968 · live from the CMS NPI Registry
Broadway Healthcare, LLC
Skilled Nursing Facility in Muskogee, OK. National Provider Identifier 1053095968, active.
NPI record
| NPI | 1053095968 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 1622 E Broadway St, Muskogee, OK 74403 |
| Practice phone | 918-683-2851 |
| Mailing address | 477 N Lindbergh Blvd Ste 310, Saint Louis, MO 63141 |
| Enumerated | June 12, 2023 |
| Last updated | June 12, 2023 |
| Authorized official | Naftali Friedman, Manager |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility primary | 314000000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.