Provider Demographics
NPI:1295843100
Name:FAR WEST HEALTH CARE INC
Entity Type:Organization
Organization Name:FAR WEST HEALTH CARE INC
Other - Org Name:ELK CITY NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JODI
Authorized Official - Middle Name:L
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-225-2811
Mailing Address - Street 1:301 GARRETT ST
Mailing Address - Street 2:
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73644-3113
Mailing Address - Country:US
Mailing Address - Phone:580-225-2811
Mailing Address - Fax:580-225-3532
Practice Address - Street 1:301 GARRETT ST
Practice Address - Street 2:
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-3113
Practice Address - Country:US
Practice Address - Phone:580-225-2811
Practice Address - Fax:580-225-3532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNH0503-0503313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
375479Medicare ID - Type Unspecified