Provider Demographics
NPI:1417327495
Name:CLAREMORE OPERATIONS, LLC
Entity Type:Organization
Organization Name:CLAREMORE OPERATIONS, LLC
Other - Org Name:CLAREMORE NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEROIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-943-1144
Mailing Address - Street 1:920 E 16TH ST
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-3165
Mailing Address - Country:US
Mailing Address - Phone:918-341-1717
Mailing Address - Fax:918-341-9199
Practice Address - Street 1:920 E 16TH ST
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-3165
Practice Address - Country:US
Practice Address - Phone:918-341-1717
Practice Address - Fax:918-341-9199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-02
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNH6601-6601314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility