Provider Demographics
NPI:1417048273
Name:COLE BROS. INC.
Entity Type:Organization
Organization Name:COLE BROS. INC.
Other - Org Name:WINLEN OAKS LIVING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO-MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:REDEKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-335-3016
Mailing Address - Street 1:313 E LUCILLE AVE
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:OK
Mailing Address - Zip Code:73542-1427
Mailing Address - Country:US
Mailing Address - Phone:580-335-5591
Mailing Address - Fax:580-335-5323
Practice Address - Street 1:313 E LUCILLE AVE
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:OK
Practice Address - Zip Code:73542-1427
Practice Address - Country:US
Practice Address - Phone:580-335-5591
Practice Address - Fax:580-335-5323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNH71027102314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK375450Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER