Robertson Health Care LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH2702 Issued in OK

Legal business name

ROBERTSON HEALTH CARE LLC

Doing business as

Servant Living Center

Practice address

616 S Front St
Medford, OK 73759-1714

Phone

(580) 395-2105

Fax

(580) 395-2070

NPI assigned

Feb 28, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Travis Robertson

Title

Member

Phone

(580) 395-2105

Specialties & licenses 1

Addresses

Other names 1

• Servant Living Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1393545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404691200000",
    "number": "1891110797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 S FRONT ST",
            "city": "MEDFORD",
            "state": "OK",
            "postal_code": "737591714",
            "telephone_number": "580-395-2105",
            "fax_number": "580-395-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 S FRONT ST",
            "city": "MEDFORD",
            "state": "OK",
            "postal_code": "737591714",
            "telephone_number": "580-395-2105",
            "fax_number": "580-395-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTSON HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-28",
        "last_updated": "2014-07-07",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "580-395-2105"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "NH2702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Servant Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Medkan Pharmacy Inc (GC Drug)
• Medkan Pharmacy Inc (GC Drug LTC)
• Michael F Flanagan, Receiver for Medfors Nursing Home (Medford Nursing Home)
• Miller EMS LLC
• Kristina Nelson
• Servant Living Center - Medford LLC
• Linda Sue Woodruff, ARNP

• Skilled Nursing Facility in Medford, OK
• Providers in Medford, OK by specialty
• Skilled Nursing Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.