Provider Demographics
NPI:1245348085
Name:VILLAGE HEALTH CARE CENTER INC
Entity type:Organization
Organization Name:VILLAGE HEALTH CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SOMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-251-5389
Mailing Address - Street 1:124 S ELM PL
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-4031
Mailing Address - Country:US
Mailing Address - Phone:918-251-5389
Mailing Address - Fax:918-258-4736
Practice Address - Street 1:1709 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-6502
Practice Address - Country:US
Practice Address - Phone:918-251-5389
Practice Address - Fax:918-258-4736
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 Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Not Answered385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK375171Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER