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SULPHUR MANOR INC NPI 1508853508


NPI Information

NPI: 1508853508
Provider Name: SULPHUR MANOR INC

Doing Business As: CALLAWAY NURSING HOME

Classification: Nursing Facility/Intermediate Care Facility - 313M00000X
Entity Type: Organization

CLIA Number: 37D0671701

Address:
1300 W LINDSAY AVE
SULPHUR, OK
ZIP 73086
Phone: (580) 622-4600
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SULPHUR MANOR INC is a nursing facility intermediate care facility in Sulphur, OK. The provider is an institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. SULPHUR MANOR INC NPI is 1508853508. The provider is registered as an organization entity type.
The provider Is Doing Business As Callaway Nursing Home.

The provider's business location address is:

1300 W LINDSAY AVE
SULPHUR, OK
ZIP 73086-650
Phone: (580) 622-4600
Fax: (580) 622-5151

The provider's authorized official is Janice Pita .
The authorized official title is Insurance/medicare and has the following contact phone number (580) 622-6300.

The CLIA number assigned to this NPI record is 37D0671701 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/4/2005 and was last updated on 6/16/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1313M00000XNursing Facility/Intermediate Care FacilityNH5003-5003OKLAHOMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
137-5401MEDICARE ID-TYPE UNSPECIFIEDOKLAHOMAMEDICARE OKLAHOMA
2100776290AMEDICAIDOKLAHOMA
3000375401001OTHEROKLAHOMABLUE CROSS/BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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