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Contact Information

BLUE RIVER HEALTHCARE INC.
1105 E MAIN ST
TISHOMINGO, OK73460-2401
 Phone: 580-371-2636
 Fax: 580-371-3890
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
Indicates primary specialty

NPI Profile & details for BLUE RIVER HEALTHCARE INC.

NPI # 1528159266
LBN Legal business name BLUE RIVER HEALTHCARE INC.
Authorized official VETRESS HOLT - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 09/27/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
OK License # NH35013501
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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