Provider Demographics
NPI:1760715585
Name:ALTERNACARE INC
Entity Type:Organization
Organization Name:ALTERNACARE INC
Other - Org Name:ALTERNACARE OF SALLISAW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-686-1037
Mailing Address - Street 1:3404 W OKMULGEE ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74401-5071
Mailing Address - Country:US
Mailing Address - Phone:918-682-7773
Mailing Address - Fax:918-682-0496
Practice Address - Street 1:1100 W CHEROKEE AVE
Practice Address - Street 2:
Practice Address - City:SALLISAW
Practice Address - State:OK
Practice Address - Zip Code:74955-4025
Practice Address - Country:US
Practice Address - Phone:918-775-4845
Practice Address - Fax:918-775-4654
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALTERNACARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-11
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100804760LMedicaid
OK0140880006Medicare NSC