Colonial Plaza Management Company LLC
Organization Active NPI Skilled Nursing Facility · Cushing, OK
NPI 1750423661 · NPPES record last updated Dec 2, 2015
Key facts
- NPI
- 1750423661
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- NH6001-6001 (OK)
- Legal business name
- COLONIAL PLAZA MANAGEMENT COMPANY LLC
- Practice address
- 530 S Linwood Ave
Cushing, OK 74023-4644 - Phone
- (918) 225-2220
- Fax
- (918) 225-4447
- NPI assigned
- Feb 14, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Bob G Pope, C.O.O
- Title
- Member
- Phone
- (918) 743-7838
National Provider Directory
Locations
530 S Linwood Ave
Cushing, OK 74023
Phone (918) 225-2220
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NH6001-6001 | OK | Yes |
Addresses
Primary practice location
530 S Linwood Ave
Cushing, OK 74023-4644
Mailing address
530 S Linwood Ave
Cushing, OK 74023-4644
Phone (918) 743-7838
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20119150A | Medicaid | OK |
Other names
- Linwood Village Nursing and Retirement
Other providers in Cushing, OK
- Cimarron Surgical Care Center, LLC
- Cimarron Urgent Care Clinic, LLC
- City of Cushing
- Karri Claxton
- Madalynn Michelle-Marie Collier
- Colonial Plaza Nursing Home Inc
- Charles Cooper Jr.
- Janel Jo Cravens
- Jennifer Leigh Cuenca
- Cushing Family Pharmacy Inc
All providers in Cushing, OK · Skilled Nursing Facility in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.