NPI 1063196988 · live from the CMS NPI Registry
Fort Gibson Healthcare, LLC
Skilled Nursing Facility in Fort Gibson, OK. National Provider Identifier 1063196988, active.
NPI record
| NPI | 1063196988 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 205 E Poplar St, Fort Gibson, OK 74434 |
| Practice phone | 918-478-2456 |
| 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.