Provider Demographics
NPI:1629297031
Name:NEWKIRK NURSING CENTER, INC
Entity Type:Organization
Organization Name:NEWKIRK NURSING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DIONE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-362-3277
Mailing Address - Street 1:PO BOX 427
Mailing Address - Street 2:
Mailing Address - City:NEWKIRK
Mailing Address - State:OK
Mailing Address - Zip Code:74647-0427
Mailing Address - Country:US
Mailing Address - Phone:580-362-3277
Mailing Address - Fax:580-362-1298
Practice Address - Street 1:1351 W PECKHAM RD
Practice Address - Street 2:
Practice Address - City:NEWKIRK
Practice Address - State:OK
Practice Address - Zip Code:74647-8514
Practice Address - Country:US
Practice Address - Phone:580-362-3277
Practice Address - Fax:580-362-1298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNH3605-3605313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility