Provider Demographics
NPI:1043397060
Name:UNIVERSAL REHAB SERVICES
Entity Type:Organization
Organization Name:UNIVERSAL REHAB SERVICES
Other - Org Name:UNIVERSAL HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:BLAKE
Authorized Official - Last Name:MURDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-272-0700
Mailing Address - Street 1:114 NW 6TH ST
Mailing Address - Street 2:#104
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-6027
Mailing Address - Country:US
Mailing Address - Phone:405-272-0700
Mailing Address - Fax:405-272-0701
Practice Address - Street 1:114 NW 6TH ST
Practice Address - Street 2:#104
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-6027
Practice Address - Country:US
Practice Address - Phone:405-272-0700
Practice Address - Fax:405-272-0701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7765251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
377668Medicare ID - Type Unspecified